Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.92 / $79.81 / $218.31	Facility		$21.92	$79.81	$218.31
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.40 / $103.15 / $121.71	Facility	26	$42.40	$103.15	$121.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.81 / $42.41 / $93.85	Professional		$32.81	$42.41	$93.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.78 / $32.24 / $217.85	Professional	26	$22.78	$32.24	$217.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.88 / $14.75 / $33.29	Professional	TC	$9.88	$14.75	$33.29
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.08 / $43.21 / $54.76	Professional	26	$28.08	$43.21	$54.76
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.49 / $22.49 / $22.49	Professional	TC	$22.49	$22.49	$22.49
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $53.60 / $70.73 / $94.58	Professional		$53.60	$70.73	$94.58
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $29.76 / $42.59 / $72.67	Professional	26	$29.76	$42.59	$72.67
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $14.03 / $24.74 / $38.31	Professional	TC	$14.03	$24.74	$38.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.85 / $40.85 / $84.92	Facility		$40.85	$40.85	$84.92
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.70 / $45.70 / $45.70	Facility	26	$45.70	$45.70	$45.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.80 / $29.09 / $66.09	Professional		$18.80	$29.09	$66.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.04 / $18.30 / $43.82	Professional	26	$14.04	$18.30	$43.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $4.71 / $11.24 / $26.82	Professional	TC	$4.71	$11.24	$26.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $78.63 / $104.00	Professional		$34.29	$78.63	$104.00
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $41.44 / $54.42	Professional	26	$18.30	$41.44	$54.42
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.00 / $37.19 / $49.58	Professional	TC	$16.00	$37.19	$49.58
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.14 / $73.14 / $73.14	Professional		$73.14	$73.14	$73.14
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.92 / $34.34 / $48.97	Professional	26	$29.92	$34.34	$48.97
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $76.36 / $87.00 / $218.31	Facility		$76.36	$87.00	$218.31
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $42.40 / $121.71 / $121.71	Facility	26	$42.40	$121.71	$121.71
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $35.20 / $49.65 / $147.49	Professional		$35.20	$49.65	$147.49
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $24.16 / $42.40 / $181.21	Professional	26	$24.16	$42.40	$181.21
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $22.48 / $62.74	Professional	TC	$11.48	$22.48	$62.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.14 / $45.68 / $91.84	Professional		$25.14	$45.68	$91.84
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $40.85 / $40.85 / $84.92	Facility		$40.85	$40.85	$84.92
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $45.70 / $45.70 / $45.70	Facility	26	$45.70	$45.70	$45.70
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $18.80 / $33.34 / $70.69	Professional		$18.80	$33.34	$70.69
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.04 / $25.71 / $44.81	Professional	26	$14.04	$25.71	$44.81
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $4.71 / $11.74 / $28.30	Professional	TC	$4.71	$11.74	$28.30
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $39.19 / $52.24 / $56.40	Professional		$39.19	$52.24	$56.40
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.32 / $30.06 / $35.00	Professional	26	$29.32	$30.06	$35.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $7.51 / $23.22 / $25.75	Professional	TC	$7.51	$23.22	$25.75
United Facility/Professional Professional Modifier Low / Median / High Price $29.39 / $53.43 / $75.50	Professional		$29.39	$53.43	$75.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.48 / $31.78 / $52.00	Professional	26	$17.48	$31.78	$52.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.20 / $21.65 / $35.42	Professional	TC	$11.20	$21.65	$35.42