Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.93 / $82.52 / $82.52	Facility	26	$69.93	$82.52	$82.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.70 / $77.06 / $99.80	Professional		$48.70	$77.06	$99.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.91 / $16.80 / $133.97	Professional	26	$13.91	$16.80	$133.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.46 / $60.26 / $76.97	Professional	TC	$34.46	$60.26	$76.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.96 / $31.96 / $31.96	Professional	26	$31.96	$31.96	$31.96
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $82.81 / $90.70 / $148.34	Professional		$82.81	$90.70	$148.34
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $28.75 / $55.69	Professional	26	$19.55	$28.75	$55.69
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $45.07 / $65.64 / $112.06	Professional	TC	$45.07	$65.64	$112.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.59 / $34.59 / $34.59	Facility	26	$34.59	$34.59	$34.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.06 / $50.11 / $116.19	Professional		$39.06	$50.11	$116.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.53 / $13.51 / $30.27	Professional	26	$9.53	$13.51	$30.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.21 / $37.20 / $86.89	Professional	TC	$26.21	$37.20	$86.89
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $54.28 / $125.39 / $166.43	Professional		$54.28	$125.39	$166.43
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.86 / $26.80 / $35.11	Professional	26	$11.86	$26.80	$35.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.42 / $98.71 / $131.31	Professional	TC	$42.42	$98.71	$131.31
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $21.22 / $30.61	Professional	26	$20.05	$21.22	$30.61
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $82.52 / $82.52 / $82.52	Facility	26	$82.52	$82.52	$82.52
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $56.25 / $91.65 / $356.71	Professional		$56.25	$91.65	$356.71
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $14.25 / $22.84 / $105.62	Professional	26	$14.25	$22.84	$105.62
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $42.96 / $72.98 / $274.19	Professional	TC	$42.96	$72.98	$274.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.28 / $82.21 / $142.61	Professional		$19.28	$82.21	$142.61
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.59 / $34.59 / $34.59	Facility	26	$34.59	$34.59	$34.59
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $39.06 / $55.70 / $123.86	Professional		$39.06	$55.70	$123.86
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.53 / $18.78 / $33.31	Professional	26	$9.53	$18.78	$33.31
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.21 / $48.18 / $94.43	Professional	TC	$28.21	$48.18	$94.43
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $47.53 / $85.55 / $93.72	Professional		$47.53	$85.55	$93.72
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.94 / $20.38 / $27.00	Professional	26	$19.94	$20.38	$27.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $66.03 / $73.08	Professional	TC	$23.44	$66.03	$73.08
United Facility/Professional Professional Modifier Low / Median / High Price $46.22 / $93.36 / $140.04	Professional		$46.22	$93.36	$140.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.47 / $22.67 / $33.76	Professional	26	$12.47	$22.67	$33.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.88 / $70.69 / $109.20	Professional	TC	$38.88	$70.69	$109.20