Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.04 / $41.48 / $101.22	Facility	26	$30.04	$41.48	$101.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.56 / $226.17 / $1,018.39	Professional		$59.56	$226.17	$1,018.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.71 / $194.12 / $732.88	Professional	26	$29.71	$194.12	$732.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.75 / $40.02 / $197.51	Professional	TC	$27.75	$40.02	$197.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.63 / $52.06 / $53.00	Professional		$49.63	$52.06	$53.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.07 / $46.73 / $60.74	Professional	26	$26.07	$46.73	$60.74
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $28.37 / $35.74 / $57.70	Professional	26	$28.37	$35.74	$57.70
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $65.75 / $103.29 / $139.79	Professional		$65.75	$103.29	$139.79
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $33.02 / $52.25 / $71.98	Professional	26	$33.02	$52.25	$71.98
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $32.72 / $51.06 / $85.01	Professional	TC	$32.72	$51.06	$85.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $37.07	Facility	26	$37.07	$37.07	$37.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.13 / $83.80 / $129.94	Professional		$56.13	$83.80	$129.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.52 / $38.11 / $61.80	Professional	26	$26.52	$38.11	$61.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.01 / $43.74 / $71.69	Professional	TC	$30.01	$43.74	$71.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $75.73 / $92.79 / $103.74	Professional		$75.73	$92.79	$103.74
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.52 / $44.04 / $49.30	Professional	26	$36.52	$44.04	$49.30
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.21 / $48.75 / $54.44	Professional	TC	$39.21	$48.75	$54.44
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.90 / $95.20 / $128.96	Professional		$74.90	$95.20	$128.96
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.90 / $37.25 / $53.82	Professional	26	$34.90	$37.25	$53.82
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $28.37 / $35.74 / $57.70	Professional	26	$28.37	$35.74	$57.70
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $48.86 / $105.96	Facility	26	$31.62	$48.86	$105.96
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $62.40 / $127.30 / $891.09	Professional		$62.40	$127.30	$891.09
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $31.61 / $145.32 / $684.93	Professional	26	$31.61	$145.32	$684.93
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $29.44 / $43.32 / $120.86	Professional	TC	$29.44	$43.32	$120.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.75 / $67.54 / $136.76	Professional		$46.75	$67.54	$136.76
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $37.07 / $37.07 / $37.07	Facility	26	$37.07	$37.07	$37.07
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $58.35 / $85.38 / $130.19	Professional		$58.35	$85.38	$130.19
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.66 / $38.11 / $63.20	Professional	26	$27.66	$38.11	$63.20
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.61 / $45.08 / $71.22	Professional	TC	$30.61	$45.08	$71.22
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $33.00	Facility	26	$32.36	$32.36	$33.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $62.64 / $63.65 / $90.00	Professional		$62.64	$63.65	$90.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $31.55 / $32.36 / $33.76	Professional	26	$31.55	$32.36	$33.76
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.65 / $31.29 / $57.00	Professional	TC	$30.65	$31.29	$57.00
United Facility/Professional Professional Modifier Low / Median / High Price $58.51 / $77.33 / $123.61	Professional		$58.51	$77.33	$123.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.02 / $37.51 / $61.26	Professional	26	$29.02	$37.51	$61.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.92 / $40.34 / $64.13	Professional	TC	$28.92	$40.34	$64.13