Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.01 / $140.91 / $140.91	Facility	26	$28.01	$140.91	$140.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.78 / $48.83 / $99.92	Professional		$35.78	$48.83	$99.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.55 / $31.94 / $159.12	Professional	26	$25.55	$31.94	$159.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.51 / $18.39 / $34.36	Professional	TC	$14.51	$18.39	$34.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.03 / $48.77 / $65.02	Professional	26	$16.03	$48.77	$65.02
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $34.47 / $35.99 / $46.02	Professional	26	$34.47	$35.99	$46.02
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $55.44 / $57.53 / $57.53	Professional		$55.44	$57.53	$57.53
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $34.46 / $46.35 / $74.33	Professional	26	$34.46	$46.35	$74.33
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $20.98 / $23.24 / $45.72	Professional	TC	$20.98	$23.24	$45.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.29 / $50.29 / $50.29	Facility	26	$50.29	$50.29	$50.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.12 / $35.45 / $75.34	Professional		$24.12	$35.45	$75.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.52 / $19.78 / $48.17	Professional	26	$14.52	$19.78	$48.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.13 / $12.74 / $27.57	Professional	TC	$9.13	$12.74	$27.57
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $35.24 / $80.66 / $106.55	Professional		$35.24	$80.66	$106.55
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.16 / $47.93 / $62.87	Professional	26	$21.16	$47.93	$62.87
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.08 / $32.72 / $43.69	Professional	TC	$14.08	$32.72	$43.69
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.20 / $40.36 / $57.89	Professional	26	$35.20	$40.36	$57.89
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $34.47 / $35.99 / $46.02	Professional	26	$34.47	$35.99	$46.02
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $28.01 / $140.91 / $140.91	Facility	26	$28.01	$140.91	$140.91
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $42.21 / $53.97 / $146.94	Professional		$42.21	$53.97	$146.94
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $27.17 / $45.99 / $140.91	Professional	26	$27.17	$45.99	$140.91
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $14.99 / $21.43 / $59.35	Professional	TC	$14.99	$21.43	$59.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.62 / $43.80 / $91.16	Professional		$19.62	$43.80	$91.16
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $50.29 / $50.29 / $50.29	Facility	26	$50.29	$50.29	$50.29
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $24.21 / $42.93 / $80.09	Professional		$24.21	$42.93	$80.09
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.64 / $26.36 / $51.05	Professional	26	$14.64	$26.36	$51.05
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $9.21 / $15.01 / $29.51	Professional	TC	$9.21	$15.01	$29.51
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $46.83 / $53.15 / $57.05	Professional		$46.83	$53.15	$57.05
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $32.40 / $34.11 / $35.47	Professional	26	$32.40	$34.11	$35.47
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $14.43 / $19.44 / $21.58	Professional	TC	$14.43	$19.44	$21.58
United Facility/Professional Professional Modifier Low / Median / High Price $27.44 / $55.01 / $82.52	Professional		$27.44	$55.01	$82.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.22 / $36.75 / $59.49	Professional	26	$20.22	$36.75	$59.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $18.26 / $29.55	Professional	TC	$10.96	$18.26	$29.55