Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.01 / $17.04 / $41.63	Facility	26	$13.01	$17.04	$41.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.26 / $94.71 / $184.58	Professional		$83.26	$94.71	$184.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.45 / $12.19 / $51.30	Professional	26	$10.45	$12.19	$51.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.20 / $83.65 / $166.62	Professional	TC	$72.20	$83.65	$166.62
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.82 / $15.63 / $15.63	Professional	26	$10.82	$15.63	$15.63
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $95.97 / $99.59 / $199.84	Professional		$95.97	$99.59	$199.84
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $11.74 / $12.19 / $22.95	Professional	26	$11.74	$12.19	$22.95
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $84.23 / $87.41 / $176.88	Professional	TC	$84.23	$87.41	$176.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.64 / $154.09 / $261.66	Professional		$86.64	$154.09	$261.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $13.89 / $23.31	Professional	26	$8.36	$13.89	$23.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.23 / $139.68 / $241.50	Professional	TC	$77.23	$139.68	$241.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $117.44 / $156.82 / $376.48	Professional		$117.44	$156.82	$376.48
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.84 / $15.44 / $24.40	Professional	26	$12.84	$15.44	$24.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $100.79 / $125.53 / $178.82	Professional	TC	$100.79	$125.53	$178.82
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $13.01 / $21.72 / $42.54	Facility	26	$13.01	$21.72	$42.54
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $83.26 / $103.19 / $249.81	Professional		$83.26	$103.19	$249.81
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $11.05 / $12.56 / $29.72	Professional	26	$11.05	$12.56	$29.72
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $72.20 / $87.83 / $220.00	Professional	TC	$72.20	$87.83	$220.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $253.20 / $325.00 / $355.90	Professional		$253.20	$325.00	$355.90
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $13.50 / $13.50 / $13.50	Facility	26	$13.50	$13.50	$13.50
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $90.54 / $152.51 / $261.69	Professional		$90.54	$152.51	$261.69
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.53 / $13.86 / $23.86	Professional	26	$8.53	$13.86	$23.86
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.45 / $136.53 / $241.50	Professional	TC	$79.45	$136.53	$241.50
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $10.58 / $11.62 / $11.62	Facility	26	$10.58	$11.62	$11.62
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $90.78 / $94.05 / $121.15	Professional		$90.78	$94.05	$121.15
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.58 / $11.62 / $12.04	Professional	26	$10.58	$11.62	$12.04
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $79.17 / $82.55 / $110.57	Professional	TC	$79.17	$82.55	$110.57
United Facility/Professional Professional Modifier Low / Median / High Price $98.52 / $128.90 / $217.20	Professional		$98.52	$128.90	$217.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.55 / $13.65 / $23.02	Professional	26	$10.55	$13.65	$23.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.35 / $115.30 / $201.45	Professional	TC	$87.35	$115.30	$201.45