Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.69 / $60.26 / $129.61	Facility	26	$38.69	$60.26	$129.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.52 / $113.44 / $231.60	Professional		$52.52	$113.44	$231.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.57 / $38.71 / $63.35	Professional	26	$33.57	$38.71	$63.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.03 / $80.51 / $171.03	Professional	TC	$16.03	$80.51	$171.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.41 / $58.42 / $66.48	Professional	26	$56.41	$58.42	$66.48
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $132.51 / $148.72 / $216.09	Professional		$132.51	$148.72	$216.09
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $40.02 / $62.20 / $97.39	Professional	26	$40.02	$62.20	$97.39
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $83.55 / $95.99 / $131.21	Professional	TC	$83.55	$95.99	$131.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.71 / $44.71 / $44.71	Facility	26	$44.71	$44.71	$44.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.49 / $122.21 / $225.01	Professional		$61.49	$122.21	$225.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.42 / $50.35 / $77.63	Professional	26	$32.42	$50.35	$77.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.85 / $77.88 / $156.43	Professional	TC	$12.85	$77.88	$156.43
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $99.50 / $171.61 / $212.82	Professional		$99.50	$171.61	$212.82
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.23 / $53.43 / $59.56	Professional	26	$44.23	$53.43	$59.56
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $110.67 / $137.84 / $153.25	Professional	TC	$110.67	$137.84	$153.25
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.22 / $43.57 / $164.48	Professional		$40.22	$43.57	$164.48
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.56 / $44.26 / $66.40	Professional	26	$42.56	$44.26	$66.40
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $38.69 / $72.34 / $135.03	Facility	26	$38.69	$72.34	$135.03
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $56.06 / $131.00 / $300.54	Professional		$56.06	$131.00	$300.54
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $34.89 / $42.57 / $82.79	Professional	26	$34.89	$42.57	$82.79
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $16.03 / $92.83 / $217.74	Professional	TC	$16.03	$92.83	$217.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $59.60 / $148.74 / $256.72	Professional		$59.60	$148.74	$256.72
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $44.71 / $44.71 / $44.71	Facility	26	$44.71	$44.71	$44.71
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $64.48 / $122.21 / $240.09	Professional		$64.48	$122.21	$240.09
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.81 / $50.61 / $79.56	Professional	26	$33.81	$50.61	$79.56
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.85 / $78.56 / $156.43	Professional	TC	$12.85	$78.56	$156.43
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $38.97 / $38.97 / $45.00	Facility	26	$38.97	$38.97	$45.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $131.91 / $142.97	Professional		$126.00	$131.91	$142.97
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $38.04 / $38.97 / $45.00	Professional	26	$38.04	$38.97	$45.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $81.00 / $92.94 / $102.32	Professional	TC	$81.00	$92.94	$102.32
United Facility/Professional Professional Modifier Low / Median / High Price $91.92 / $125.01 / $221.26	Professional		$91.92	$125.01	$221.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.95 / $48.08 / $74.80	Professional	26	$35.95	$48.08	$74.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.84 / $88.68 / $152.24	Professional	TC	$38.84	$88.68	$152.24