Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.31 / $90.02 / $246.23	Facility	26	$51.31	$90.02	$246.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.57 / $82.26 / $153.16	Professional		$58.57	$82.26	$153.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.09 / $61.33 / $158.26	Professional	26	$46.09	$61.33	$158.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.34 / $31.16 / $58.83	Professional	TC	$20.34	$31.16	$58.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.25 / $29.23 / $84.77	Professional	26	$28.25	$29.23	$84.77
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $89.77 / $93.16 / $153.44	Professional		$89.77	$93.16	$153.44
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $59.90 / $62.16 / $101.61	Professional	26	$59.90	$62.16	$101.61
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $29.88 / $31.01 / $49.70	Professional	TC	$29.88	$31.01	$49.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.53 / $91.53 / $91.53	Facility	26	$91.53	$91.53	$91.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.35 / $61.12 / $134.28	Professional		$42.35	$61.12	$134.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.25 / $37.64 / $83.61	Professional	26	$28.25	$37.64	$83.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.72 / $19.05 / $43.22	Professional	TC	$12.72	$19.05	$43.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $56.82 / $129.91 / $171.40	Professional		$56.82	$129.91	$171.40
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.78 / $83.29 / $109.34	Professional	26	$36.78	$83.29	$109.34
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.04 / $46.62 / $62.06	Professional	TC	$20.04	$46.62	$62.06
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.53 / $68.84 / $98.46	Professional	26	$60.53	$68.84	$98.46
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $51.31 / $90.02 / $246.23	Facility	26	$51.31	$90.02	$246.23
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $72.04 / $101.09 / $252.21	Professional		$72.04	$101.09	$252.21
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $48.86 / $75.92 / $162.22	Professional	26	$48.86	$75.92	$162.22
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $24.98 / $37.39 / $89.99	Professional	TC	$24.98	$37.39	$89.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.03 / $83.94 / $153.66	Professional		$32.03	$83.94	$153.66
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $91.53 / $91.53 / $91.53	Facility	26	$91.53	$91.53	$91.53
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $42.35 / $74.45 / $136.15	Professional		$42.35	$74.45	$136.15
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.25 / $53.03 / $91.05	Professional	26	$28.25	$53.03	$91.05
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.77 / $22.02 / $44.25	Professional	TC	$13.77	$22.02	$44.25
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $75.31 / $89.03 / $95.40	Professional		$75.31	$89.03	$95.40
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $59.31 / $60.28 / $66.00	Professional	26	$59.31	$60.28	$66.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $30.15 / $33.40	Professional	TC	$18.62	$30.15	$33.40
United Facility/Professional Professional Modifier Low / Median / High Price $52.66 / $88.98 / $135.88	Professional		$52.66	$88.98	$135.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.17 / $63.95 / $103.41	Professional	26	$35.17	$63.95	$103.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.68 / $25.78 / $47.31	Professional	TC	$15.68	$25.78	$47.31