Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.98 / $18.55 / $44.65	Facility	26	$12.98	$18.55	$44.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.43 / $51.24 / $232.00	Professional		$42.43	$51.24	$232.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.09 / $14.06 / $33.79	Professional	26	$12.09	$14.06	$33.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.82 / $36.86 / $69.03	Professional	TC	$29.82	$36.86	$69.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.22 / $40.03 / $51.22	Professional		$32.22	$40.03	$51.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.62 / $10.82 / $25.94	Professional	26	$10.62	$10.82	$25.94
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $52.24 / $81.36 / $100.18	Professional		$52.24	$81.36	$100.18
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $14.10 / $23.37 / $28.81	Professional	26	$14.10	$23.37	$28.81
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $38.14 / $57.98 / $73.55	Professional	TC	$38.14	$57.98	$73.55
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.20 / $16.20 / $16.20	Facility	26	$16.20	$16.20	$16.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.38 / $66.45 / $101.40	Professional		$39.38	$66.45	$101.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $18.14 / $28.63	Professional	26	$10.35	$18.14	$28.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.05 / $48.37 / $73.93	Professional	TC	$29.05	$48.37	$73.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $61.12 / $72.51 / $91.40	Professional		$61.12	$72.51	$91.40
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.41 / $18.54 / $29.30	Professional	26	$15.41	$18.54	$29.30
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.73 / $56.75 / $80.73	Professional	TC	$45.73	$56.75	$80.73
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.02 / $93.64 / $95.99	Professional		$60.02	$93.64	$95.99
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.89 / $15.75 / $15.95	Professional	26	$14.89	$15.75	$15.95
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.98 / $18.82 / $45.22	Facility	26	$12.98	$18.82	$45.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $43.95 / $57.77 / $138.03	Professional		$43.95	$57.77	$138.03
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $15.08 / $36.45	Professional	26	$12.28	$15.08	$36.45
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $31.18 / $42.07 / $78.90	Professional	TC	$31.18	$42.07	$78.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.32 / $53.25 / $88.79	Professional		$15.32	$53.25	$88.79
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $16.20 / $16.20 / $16.20	Facility	26	$16.20	$16.20	$16.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $41.15 / $66.06 / $103.45	Professional		$41.15	$66.06	$103.45
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.64 / $18.19 / $28.65	Professional	26	$10.64	$18.19	$28.65
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.07 / $47.95 / $74.79	Professional	TC	$29.07	$47.95	$74.79
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.27 / $14.27 / $16.57	Facility	26	$14.27	$14.27	$16.57
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $49.67 / $58.61	Professional		$48.90	$49.67	$58.61
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.94 / $14.27 / $16.57	Professional	26	$13.94	$14.27	$16.57
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.65 / $35.40 / $42.04	Professional	TC	$34.65	$35.40	$42.04
United Facility/Professional Professional Modifier Low / Median / High Price $37.54 / $56.38 / $98.88	Professional		$37.54	$56.38	$98.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.60 / $16.38 / $27.47	Professional	26	$10.60	$16.38	$27.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.23 / $42.14 / $69.95	Professional	TC	$28.23	$42.14	$69.95