Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.43 / $28.26 / $53.11	Facility	26	$24.43	$28.26	$53.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.68 / $101.59 / $505.00	Professional		$78.68	$101.59	$505.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.21 / $27.30 / $71.69	Professional	26	$22.21	$27.30	$71.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.79 / $71.05 / $140.53	Professional	TC	$56.79	$71.05	$140.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.39 / $79.23 / $86.91	Professional		$63.39	$79.23	$86.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.36 / $22.73 / $37.45	Professional	26	$19.36	$22.73	$37.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $118.59 / $118.59 / $120.07	Professional	TC	$118.59	$118.59	$120.07
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $103.08 / $151.72 / $175.58	Professional		$103.08	$151.72	$175.58
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $25.85 / $42.38 / $52.73	Professional	26	$25.85	$42.38	$52.73
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $77.23 / $112.20 / $131.55	Professional	TC	$77.23	$112.20	$131.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.72 / $29.72 / $29.72	Facility	26	$29.72	$29.72	$29.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.96 / $124.04 / $197.64	Professional		$83.96	$124.04	$197.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.73 / $34.46 / $53.16	Professional	26	$20.73	$34.46	$53.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $62.03 / $91.09 / $147.13	Professional	TC	$62.03	$91.09	$147.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $103.94 / $149.01 / $255.28	Professional		$103.94	$149.01	$255.28
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.30 / $37.42 / $58.61	Professional	26	$29.30	$37.42	$58.61
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $96.40 / $123.94 / $196.66	Professional	TC	$96.40	$123.94	$196.66
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.03 / $132.04 / $140.38	Professional		$120.03	$132.04	$140.38
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.88 / $31.77 / $37.72	Professional	26	$28.88	$31.77	$37.72
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $23.53 / $34.11 / $81.18	Facility	26	$23.53	$34.11	$81.18
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $86.07 / $120.23 / $392.78	Professional		$86.07	$120.23	$392.78
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $23.53 / $32.68 / $76.29	Professional	26	$23.53	$32.68	$76.29
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $61.40 / $82.91 / $184.06	Professional	TC	$61.40	$82.91	$184.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.61 / $105.20 / $193.51	Professional		$27.61	$105.20	$193.51
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $29.72 / $29.72 / $29.72	Facility	26	$29.72	$29.72	$29.72
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $85.07 / $124.04 / $196.96	Professional		$85.07	$124.04	$196.96
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.33 / $34.68 / $53.16	Professional	26	$21.33	$34.68	$53.16
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.47 / $91.11 / $147.13	Professional	TC	$63.47	$91.11	$147.13
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $25.87 / $25.87 / $30.65	Facility	26	$25.87	$25.87	$30.65
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $99.55 / $102.69 / $111.41	Professional		$99.55	$102.69	$111.41
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $25.14 / $25.95 / $30.65	Professional	26	$25.14	$25.95	$30.65
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $68.90 / $76.81 / $84.57	Professional	TC	$68.90	$76.81	$84.57
United Facility/Professional Professional Modifier Low / Median / High Price $85.19 / $114.96 / $202.64	Professional		$85.19	$114.96	$202.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.48 / $30.42 / $51.20	Professional	26	$22.48	$30.42	$51.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.92 / $90.22 / $151.62	Professional	TC	$61.92	$90.22	$151.62