Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.34 / $57.67 / $146.04	Facility	26	$42.34	$57.67	$146.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $63.35 / $337.00	Professional		$55.57	$63.35	$337.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.06 / $43.97 / $213.00	Professional	26	$38.06	$43.97	$213.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.89 / $19.38 / $35.53	Professional	TC	$15.89	$19.38	$35.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $49.95 / $49.95 / $49.95	Professional		$49.95	$49.95	$49.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.71 / $44.49 / $51.33	Professional	26	$35.71	$44.49	$51.33
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $64.79 / $100.86 / $116.03	Professional		$64.79	$100.86	$116.03
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $46.35 / $72.22 / $100.78	Professional	26	$46.35	$72.22	$100.78
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $18.43 / $28.64 / $33.57	Professional	TC	$18.43	$28.64	$33.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.32 / $52.32 / $52.32	Facility	26	$52.32	$52.32	$52.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.18 / $76.04 / $120.23	Professional		$53.18	$76.04	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.17 / $53.36 / $85.83	Professional	26	$37.17	$53.36	$85.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.70 / $22.68 / $34.47	Professional	TC	$15.70	$22.68	$34.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $71.45 / $83.11 / $99.95	Professional		$71.45	$83.11	$99.95
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.26 / $61.84 / $69.15	Professional	26	$51.26	$61.84	$69.15
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.10 / $27.43 / $30.79	Professional	TC	$22.10	$27.43	$30.79
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.52 / $73.52 / $73.52	Professional		$73.52	$73.52	$73.52
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.84 / $53.95 / $74.81	Professional	26	$49.84	$53.95	$74.81
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $44.65 / $67.84 / $155.86	Facility	26	$44.65	$67.84	$155.86
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $56.22 / $68.59 / $189.07	Professional		$56.22	$68.59	$189.07
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $39.45 / $52.26 / $176.41	Professional	26	$39.45	$52.26	$176.41
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $16.35 / $21.18 / $43.95	Professional	TC	$16.35	$21.18	$43.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $29.30 / $85.70 / $127.00	Professional		$29.30	$85.70	$127.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $52.32 / $52.32 / $52.32	Facility	26	$52.32	$52.32	$52.32
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $54.55 / $76.17 / $125.68	Professional		$54.55	$76.17	$125.68
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.78 / $53.40 / $89.01	Professional	26	$38.78	$53.40	$89.01
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.02 / $22.72 / $37.38	Professional	TC	$16.02	$22.72	$37.38
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $44.94 / $44.94 / $47.00	Facility	26	$44.94	$44.94	$47.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $61.78 / $62.95 / $68.00	Professional		$61.78	$62.95	$68.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $43.91 / $44.94 / $47.00	Professional	26	$43.91	$44.94	$47.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $17.67 / $18.01 / $21.00	Professional	TC	$17.67	$18.01	$21.00
United Facility/Professional Professional Modifier Low / Median / High Price $57.67 / $73.86 / $121.41	Professional		$57.67	$73.86	$121.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.67 / $53.25 / $86.19	Professional	26	$41.67	$53.25	$86.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.14 / $22.41 / $35.83	Professional	TC	$16.14	$22.41	$35.83