Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.64 / $74.33 / $162.94	Facility	26	$48.64	$74.33	$162.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.36 / $105.29 / $421.44	Professional		$80.36	$105.29	$421.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.48 / $48.29 / $218.00	Professional	26	$41.48	$48.29	$218.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.92 / $54.64 / $84.67	Professional	TC	$34.92	$54.64	$84.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.73 / $71.73 / $71.73	Professional		$71.73	$71.73	$71.73
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.75 / $48.34 / $73.52	Professional	26	$38.75	$48.34	$73.52
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $93.28 / $147.51 / $339.98	Professional		$93.28	$147.51	$339.98
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $50.37 / $78.84 / $110.05	Professional	26	$50.37	$78.84	$110.05
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $42.91 / $66.09 / $256.23	Professional	TC	$42.91	$66.09	$256.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.93 / $56.93 / $56.93	Facility	26	$56.93	$56.93	$56.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.15 / $138.26 / $243.10	Professional		$85.15	$138.26	$243.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.43 / $58.01 / $94.03	Professional	26	$40.43	$58.01	$94.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.11 / $73.14 / $172.74	Professional	TC	$40.11	$73.14	$172.74
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $107.04 / $146.25 / $191.43	Professional		$107.04	$146.25	$191.43
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $55.67 / $67.18 / $74.98	Professional	26	$55.67	$67.18	$74.98
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.37 / $63.91 / $71.26	Professional	TC	$51.37	$63.91	$71.26
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.25 / $184.33 / $239.60	Professional		$51.25	$184.33	$239.60
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.69 / $56.38 / $90.99	Professional	26	$53.69	$56.38	$90.99
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $48.64 / $86.06 / $169.75	Facility	26	$48.64	$86.06	$169.75
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $82.21 / $115.83 / $275.67	Professional		$82.21	$115.83	$275.67
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $43.42 / $58.90 / $144.46	Professional	26	$43.42	$58.90	$144.46
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $37.00 / $61.86 / $131.18	Professional	TC	$37.00	$61.86	$131.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.11 / $96.54 / $195.88	Professional		$68.11	$96.54	$195.88
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $56.93 / $56.93 / $56.93	Facility	26	$56.93	$56.93	$56.93
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $85.15 / $139.34 / $231.17	Professional		$85.15	$139.34	$231.17
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.28 / $58.16 / $96.69	Professional	26	$42.28	$58.16	$96.69
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.47 / $70.62 / $172.16	Professional	TC	$40.47	$70.62	$172.16
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $49.23 / $49.23 / $51.00	Facility	26	$49.23	$49.23	$51.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $89.29 / $90.64 / $221.00	Professional		$89.29	$90.64	$221.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $48.13 / $49.23 / $51.33	Professional	26	$48.13	$49.23	$51.33
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $40.54 / $41.41 / $170.00	Professional	TC	$40.54	$41.41	$170.00
United Facility/Professional Professional Modifier Low / Median / High Price $83.56 / $116.11 / $198.56	Professional		$83.56	$116.11	$198.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.14 / $57.56 / $95.36	Professional	26	$45.14	$57.56	$95.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.28 / $55.49 / $109.49	Professional	TC	$38.28	$55.49	$109.49