Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.01 / $34.54 / $73.48	Facility	26	$25.01	$34.54	$73.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.24 / $100.76 / $223.88	Professional		$82.24	$100.76	$223.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.03 / $26.32 / $69.75	Professional	26	$23.03	$26.32	$69.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.76 / $74.73 / $115.60	Professional	TC	$59.76	$74.73	$115.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $59.02 / $73.78 / $93.92	Professional		$59.02	$73.78	$93.92
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.85 / $24.49 / $40.92	Professional	26	$19.85	$24.49	$40.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $95.77 / $99.38 / $160.01	Professional		$95.77	$99.38	$160.01
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $26.17 / $27.16 / $50.47	Professional	26	$26.17	$27.16	$50.47
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $69.61 / $72.23 / $114.42	Professional	TC	$69.61	$72.23	$114.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $30.07	Facility	26	$30.07	$30.07	$30.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.11 / $113.96 / $183.44	Professional		$74.11	$113.96	$183.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.27 / $32.00 / $51.81	Professional	26	$19.27	$32.00	$51.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $82.55 / $134.09	Professional	TC	$53.70	$82.55	$134.09
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $106.76 / $128.16 / $154.40	Professional		$106.76	$128.16	$154.40
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.69 / $34.39 / $54.21	Professional	26	$28.69	$34.39	$54.21
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.35 / $103.66 / $147.60	Professional	TC	$83.35	$103.66	$147.60
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.17 / $120.00 / $120.77	Professional		$114.17	$120.00	$120.77
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.64 / $32.38 / $43.37	Professional	26	$28.64	$32.38	$43.37
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.49 / $125.49 / $125.49	Professional	TC	$125.49	$125.49	$125.49
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $25.01 / $37.28 / $82.25	Facility	26	$25.01	$37.28	$82.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $87.14 / $110.76 / $297.24	Professional		$87.14	$110.76	$297.24
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $23.66 / $33.33 / $70.20	Professional	26	$23.66	$33.33	$70.20
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $63.32 / $82.09 / $196.54	Professional	TC	$63.32	$82.09	$196.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.26 / $105.15 / $210.90	Professional		$39.26	$105.15	$210.90
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $30.07 / $30.07 / $30.07	Facility	26	$30.07	$30.07	$30.07
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $75.78 / $113.40 / $186.32	Professional		$75.78	$113.40	$186.32
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.51 / $31.83 / $52.81	Professional	26	$19.51	$31.83	$52.81
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.17 / $82.21 / $134.66	Professional	TC	$56.17	$82.21	$134.66
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $26.19 / $26.19 / $40.00	Facility	26	$26.19	$26.19	$40.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $94.66 / $96.04 / $106.50	Professional		$94.66	$96.04	$106.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $25.46 / $26.26 / $40.00	Professional	26	$25.46	$26.26	$40.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $66.50 / $69.84 / $76.91	Professional	TC	$66.50	$69.84	$76.91
United Facility/Professional Professional Modifier Low / Median / High Price $78.12 / $100.57 / $172.12	Professional		$78.12	$100.57	$172.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.24 / $30.79 / $51.87	Professional	26	$24.24	$30.79	$51.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.53 / $73.67 / $121.53	Professional	TC	$57.53	$73.67	$121.53