Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.82 / $39.61 / $108.37	Facility	26	$22.82	$39.61	$108.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.23 / $57.09 / $141.77	Professional		$46.23	$57.09	$141.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.37 / $25.46 / $71.76	Professional	26	$18.37	$25.46	$71.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.86 / $33.59 / $95.32	Professional	TC	$27.86	$33.59	$95.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.22 / $13.22 / $39.29	Professional	26	$13.22	$13.22	$39.29
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $77.68 / $83.07 / $127.94	Professional		$77.68	$83.07	$127.94
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $27.15 / $36.24 / $69.22	Professional	26	$27.15	$36.24	$69.22
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $30.16 / $52.45 / $76.64	Professional	TC	$30.16	$52.45	$76.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.58 / $46.58 / $46.58	Facility	26	$46.58	$46.58	$46.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.80 / $40.67 / $92.10	Professional		$27.80	$40.67	$92.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $17.17 / $39.25	Professional	26	$12.80	$17.17	$39.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.63 / $23.84 / $57.21	Professional	TC	$14.63	$23.84	$57.21
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $50.53 / $116.45 / $154.47	Professional		$50.53	$116.45	$154.47
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.63 / $37.61 / $49.40	Professional	26	$16.63	$37.61	$49.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.90 / $78.84 / $105.08	Professional	TC	$33.90	$78.84	$105.08
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.92 / $90.92 / $90.92	Professional		$90.92	$90.92	$90.92
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.21 / $28.78 / $48.31	Professional	26	$27.21	$28.78	$48.31
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $22.82 / $39.61 / $108.37	Facility	26	$22.82	$39.61	$108.37
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $46.23 / $64.43 / $179.11	Professional		$46.23	$64.43	$179.11
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $21.59 / $36.77 / $105.05	Professional	26	$21.59	$36.77	$105.05
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $31.03 / $41.71 / $165.74	Professional	TC	$31.03	$41.71	$165.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $80.00 / $142.80	Professional		$38.54	$80.00	$142.80
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $46.58 / $46.58 / $46.58	Facility	26	$46.58	$46.58	$46.58
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $28.89 / $46.35 / $100.30	Professional		$28.89	$46.35	$100.30
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $24.38 / $41.70	Professional	26	$12.80	$24.38	$41.70
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.63 / $26.63 / $61.04	Professional	TC	$14.63	$26.63	$61.04
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $46.74 / $65.52 / $71.38	Professional		$46.74	$65.52	$71.38
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.14 / $26.76 / $33.00	Professional	26	$26.14	$26.76	$33.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $16.51 / $39.83 / $44.20	Professional	TC	$16.51	$39.83	$44.20
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $66.55 / $125.80	Professional		$34.67	$66.55	$125.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.77 / $28.67 / $52.71	Professional	26	$15.77	$28.67	$52.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.83 / $37.88 / $56.82	Professional	TC	$20.83	$37.88	$56.82