Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.11 / $30.53 / $74.69	Facility	26	$22.11	$30.53	$74.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.42 / $70.65 / $196.88	Professional		$33.42	$70.65	$196.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.06 / $27.58 / $73.14	Professional	26	$21.06	$27.58	$73.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.42 / $47.17 / $133.37	Professional	TC	$12.42	$47.17	$133.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.39 / $32.39 / $32.39	Professional		$32.39	$32.39	$32.39
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.48 / $23.04 / $39.90	Professional	26	$18.48	$23.04	$39.90
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $20.81 / $26.27 / $42.41	Professional	26	$20.81	$26.27	$42.41
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $40.22 / $41.73 / $147.88	Professional		$40.22	$41.73	$147.88
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $24.01 / $24.92 / $52.28	Professional	26	$24.01	$24.92	$52.28
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $16.21 / $16.82 / $95.57	Professional	TC	$16.21	$16.82	$95.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.11 / $27.11 / $27.11	Facility	26	$27.11	$27.11	$27.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.63 / $77.73 / $132.69	Professional		$35.63	$77.73	$132.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.21 / $31.45 / $46.83	Professional	26	$20.21	$31.45	$46.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.82 / $46.96 / $87.23	Professional	TC	$13.82	$46.96	$87.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.99 / $62.92 / $100.36	Professional		$45.99	$62.92	$100.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.55 / $32.04 / $35.79	Professional	26	$26.55	$32.04	$35.79
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.45 / $24.11 / $27.12	Professional	TC	$19.45	$24.11	$27.12
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.86 / $89.92 / $93.49	Professional		$76.86	$89.92	$93.49
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.99 / $29.54 / $38.76	Professional	26	$25.99	$29.54	$38.76
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $24.18 / $25.67 / $42.41	Professional	26	$24.18	$25.67	$42.41
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $22.11 / $35.40 / $78.19	Facility	26	$22.11	$35.40	$78.19
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $70.19 / $191.62	Professional		$35.15	$70.19	$191.62
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $22.11 / $34.20 / $72.89	Professional	26	$22.11	$34.20	$72.89
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $13.04 / $28.08 / $68.39	Professional	TC	$13.04	$28.08	$68.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.77 / $45.98 / $98.50	Professional		$25.77	$45.98	$98.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $27.11 / $27.11 / $27.11	Facility	26	$27.11	$27.11	$27.11
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $37.94 / $80.88 / $133.83	Professional		$37.94	$80.88	$133.83
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.44 / $32.15 / $51.69	Professional	26	$20.44	$32.15	$51.69
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.29 / $50.41 / $87.84	Professional	TC	$15.29	$50.41	$87.84
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $23.45 / $23.45 / $28.50	Facility	26	$23.45	$23.45	$28.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $36.39 / $37.04 / $85.00	Professional		$36.39	$37.04	$85.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.92 / $23.45 / $28.50	Professional	26	$22.92	$23.45	$28.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $13.34 / $13.59 / $56.50	Professional	TC	$13.34	$13.59	$56.50
United Facility/Professional Professional Modifier Low / Median / High Price $41.72 / $61.78 / $108.55	Professional		$41.72	$61.78	$108.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.63 / $29.13 / $47.44	Professional	26	$21.63	$29.13	$47.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.09 / $29.03 / $67.73	Professional	TC	$20.09	$29.03	$67.73