Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.13 / $97.62 / $115.19	Facility	26	$40.13	$97.62	$115.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.40 / $90.04 / $319.75	Professional		$45.40	$90.04	$319.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.36 / $26.25 / $471.78	Professional	26	$18.36	$26.25	$471.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.36 / $64.13 / $136.62	Professional	TC	$27.36	$64.13	$136.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.32 / $50.32 / $50.32	Professional		$50.32	$50.32	$50.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $40.75 / $40.75 / $53.16	Professional	26	$40.75	$40.75	$53.16
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $106.68 / $110.70 / $181.87	Professional		$106.68	$110.70	$181.87
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $28.17 / $36.74 / $51.23	Professional	26	$28.17	$36.74	$51.23
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $73.70 / $81.47 / $136.18	Professional	TC	$73.70	$81.47	$136.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.39 / $63.39 / $63.39	Facility	26	$63.39	$63.39	$63.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.32 / $62.38 / $124.13	Professional		$34.32	$62.38	$124.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.29 / $18.12 / $41.60	Professional	26	$13.29	$18.12	$41.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.35 / $40.70 / $90.47	Professional	TC	$20.35	$40.70	$90.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $161.56 / $213.55	Professional		$69.84	$161.56	$213.55
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $38.96 / $51.14	Professional	26	$17.23	$38.96	$51.14
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.61 / $122.60 / $162.43	Professional	TC	$52.61	$122.60	$162.43
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.77 / $116.30 / $123.02	Professional		$77.77	$116.30	$123.02
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.04 / $32.72 / $50.71	Professional	26	$29.04	$32.72	$50.71
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $131.31 / $131.31 / $131.31	Professional	TC	$131.31	$131.31	$131.31
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $40.13 / $115.19 / $115.19	Facility	26	$40.13	$115.19	$115.19
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $63.95 / $109.55 / $458.55	Professional		$63.95	$109.55	$458.55
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $22.53 / $43.84 / $476.83	Professional	26	$22.53	$43.84	$476.83
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $39.25 / $83.82 / $343.37	Professional	TC	$39.25	$83.82	$343.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.00 / $100.41 / $183.22	Professional		$28.00	$100.41	$183.22
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $63.39 / $63.39 / $63.39	Facility	26	$63.39	$63.39	$63.39
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $34.32 / $63.98 / $134.34	Professional		$34.32	$63.98	$134.34
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.29 / $26.22 / $41.75	Professional	26	$13.29	$26.22	$41.75
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.35 / $41.80 / $95.22	Professional	TC	$20.35	$41.80	$95.22
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $75.55 / $111.03 / $120.44	Professional		$75.55	$111.03	$120.44
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $27.77 / $27.89 / $30.88	Professional	26	$27.77	$27.89	$30.88
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $83.14 / $91.53	Professional	TC	$44.67	$83.14	$91.53
United Facility/Professional Professional Modifier Low / Median / High Price $49.29 / $87.00 / $138.79	Professional		$49.29	$87.00	$138.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.37 / $29.76 / $48.64	Professional	26	$16.37	$29.76	$48.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.82 / $59.86 / $96.60	Professional	TC	$32.82	$59.86	$96.60