Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.37 / $29.10 / $65.18	Facility	26	$20.37	$29.10	$65.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.96 / $62.96 / $112.48	Professional		$53.96	$62.96	$112.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.67 / $20.37 / $47.06	Professional	26	$17.67	$20.37	$47.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.29 / $43.72 / $73.38	Professional	TC	$36.29	$43.72	$73.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.78 / $15.78 / $15.78	Professional	26	$15.78	$15.78	$15.78
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $63.40 / $65.79 / $114.60	Professional		$63.40	$65.79	$114.60
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $20.81 / $21.59 / $42.58	Professional	26	$20.81	$21.59	$42.58
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $42.59 / $44.20 / $74.17	Professional	TC	$42.59	$44.20	$74.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.92 / $23.92 / $23.92	Facility	26	$23.92	$23.92	$23.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $77.75 / $124.50	Professional		$48.90	$77.75	$124.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.09 / $26.13 / $42.11	Professional	26	$15.09	$26.13	$42.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.86 / $52.13 / $81.79	Professional	TC	$33.86	$52.13	$81.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $73.76 / $84.74 / $104.94	Professional		$73.76	$84.74	$104.94
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.77 / $27.35 / $43.16	Professional	26	$22.77	$27.35	$43.16
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.99 / $63.44 / $90.33	Professional	TC	$50.99	$63.44	$90.33
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.22 / $22.97 / $229.45	Professional	26	$22.22	$22.97	$229.45
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $20.37 / $37.28 / $66.61	Facility	26	$20.37	$37.28	$66.61
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $53.96 / $72.47 / $175.39	Professional		$53.96	$72.47	$175.39
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $18.11 / $22.52 / $55.58	Professional	26	$18.11	$22.52	$55.58
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $36.29 / $49.34 / $119.80	Professional	TC	$36.29	$49.34	$119.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.38 / $133.33 / $176.40	Professional		$30.38	$133.33	$176.40
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $23.92 / $23.92 / $23.92	Facility	26	$23.92	$23.92	$23.92
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $50.95 / $77.59 / $124.27	Professional		$50.95	$77.59	$124.27
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.83 / $26.08 / $42.91	Professional	26	$15.83	$26.08	$42.91
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.81 / $52.13 / $85.08	Professional	TC	$34.81	$52.13	$85.08
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $20.58 / $20.58 / $21.00	Facility	26	$20.58	$20.58	$21.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $62.62 / $67.62	Professional		$61.00	$62.62	$67.62
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $20.07 / $20.58 / $21.34	Professional	26	$20.07	$20.58	$21.34
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $40.00 / $42.04 / $46.29	Professional	TC	$40.00	$42.04	$46.29
United Facility/Professional Professional Modifier Low / Median / High Price $54.86 / $68.62 / $119.24	Professional		$54.86	$68.62	$119.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.02 / $24.55 / $41.80	Professional	26	$20.02	$24.55	$41.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.22 / $46.15 / $76.80	Professional	TC	$35.22	$46.15	$76.80