Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.14 / $23.35 / $51.68	Facility	26	$16.14	$23.35	$51.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.59 / $43.86 / $61.34	Professional		$37.59	$43.86	$61.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.93 / $15.63 / $31.94	Professional	26	$13.93	$15.63	$31.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $28.30 / $50.76	Professional	TC	$23.51	$28.30	$50.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.98 / $50.98 / $50.98	Professional		$50.98	$50.98	$50.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $28.84 / $28.84	Professional	26	$19.05	$28.84	$28.84
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $45.01 / $46.71 / $74.20	Professional		$45.01	$46.71	$74.20
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $17.02 / $30.08	Professional	26	$16.39	$17.02	$30.08
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $28.61 / $29.69 / $47.25	Professional	TC	$28.61	$29.69	$47.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.82 / $18.82 / $18.82	Facility	26	$18.82	$18.82	$18.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.04 / $55.67 / $87.12	Professional		$35.04	$55.67	$87.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.84 / $19.22 / $31.58	Professional	26	$11.84	$19.22	$31.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.95 / $35.29 / $55.75	Professional	TC	$22.95	$35.29	$55.75
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $48.53 / $62.35 / $72.03	Professional		$48.53	$62.35	$72.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.05 / $21.66 / $33.99	Professional	26	$18.05	$21.66	$33.99
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.26 / $42.59 / $60.63	Professional	TC	$34.26	$42.59	$60.63
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.67 / $18.71 / $24.03	Professional	26	$16.67	$18.71	$24.03
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $16.14 / $24.49 / $52.81	Facility	26	$16.14	$24.49	$52.81
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $38.76 / $45.87 / $83.22	Professional		$38.76	$45.87	$83.22
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $14.08 / $16.57 / $33.27	Professional	26	$14.08	$16.57	$33.27
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $24.61 / $30.28 / $53.95	Professional	TC	$24.61	$30.28	$53.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $29.70 / $72.90 / $99.70	Professional		$29.70	$72.90	$99.70
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $18.82 / $18.82 / $18.82	Facility	26	$18.82	$18.82	$18.82
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $35.04 / $55.19 / $86.42	Professional		$35.04	$55.19	$86.42
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.06 / $19.22 / $32.47	Professional	26	$12.06	$19.22	$32.47
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.95 / $35.11 / $55.60	Professional	TC	$22.95	$35.11	$55.60
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $16.22 / $16.22	Facility	26	$15.00	$16.22	$16.22
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $44.69 / $45.30 / $52.00	Professional		$44.69	$45.30	$52.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $15.00 / $16.23 / $16.87	Professional	26	$15.00	$16.23	$16.87
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $28.48 / $29.08 / $37.00	Professional	TC	$28.48	$29.08	$37.00
United Facility/Professional Professional Modifier Low / Median / High Price $39.96 / $49.78 / $85.59	Professional		$39.96	$49.78	$85.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.15 / $18.76 / $32.22	Professional	26	$14.15	$18.76	$32.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.35 / $32.47 / $51.15	Professional	TC	$24.35	$32.47	$51.15