Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.50 / $63.87 / $174.70	Facility	26	$36.50	$63.87	$174.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.18 / $107.74 / $188.57	Professional		$92.18	$107.74	$188.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.72 / $42.30 / $128.00	Professional	26	$33.72	$42.30	$128.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.64 / $61.39 / $128.44	Professional	TC	$56.64	$61.39	$128.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.51 / $60.51 / $60.51	Professional	26	$60.51	$60.51	$60.51
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $112.67 / $159.74 / $228.07	Professional		$112.67	$159.74	$228.07
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $42.10 / $58.50 / $149.43	Professional	26	$42.10	$58.50	$149.43
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $70.56 / $101.24 / $135.72	Professional	TC	$70.56	$101.24	$135.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.15 / $97.15 / $97.15	Facility	26	$97.15	$97.15	$97.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.39 / $93.34 / $190.11	Professional		$56.39	$93.34	$190.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.59 / $32.00 / $76.06	Professional	26	$20.59	$32.00	$76.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.79 / $57.95 / $119.71	Professional	TC	$35.79	$57.95	$119.71
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $72.83 / $167.86 / $221.39	Professional		$72.83	$167.86	$221.39
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.54 / $57.81 / $75.75	Professional	26	$25.54	$57.81	$75.75
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.29 / $110.20 / $146.02	Professional	TC	$47.29	$110.20	$146.02
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.84 / $44.27 / $58.37	Professional	26	$42.84	$44.27	$58.37
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $36.50 / $63.87 / $174.70	Facility	26	$36.50	$63.87	$174.70
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $92.18 / $129.01 / $468.47	Professional		$92.18	$129.01	$468.47
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $34.60 / $48.78 / $174.70	Professional	26	$34.60	$48.78	$174.70
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $58.26 / $80.23 / $293.77	Professional	TC	$58.26	$80.23	$293.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.28 / $104.86 / $195.15	Professional		$41.28	$104.86	$195.15
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $97.15 / $97.15 / $97.15	Facility	26	$97.15	$97.15	$97.15
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $56.39 / $106.62 / $207.55	Professional		$56.39	$106.62	$207.55
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.34 / $39.76 / $77.48	Professional	26	$20.34	$39.76	$77.48
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.79 / $66.86 / $122.51	Professional	TC	$35.79	$66.86	$122.51
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $111.72 / $115.70 / $160.00	Professional		$111.72	$115.70	$160.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.13 / $43.15 / $60.34	Professional	26	$42.13	$43.15	$60.34
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $69.59 / $72.55 / $99.66	Professional	TC	$69.59	$72.55	$99.66
United Facility/Professional Professional Modifier Low / Median / High Price $74.45 / $123.24 / $207.99	Professional		$74.45	$123.24	$207.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.47 / $45.79 / $72.69	Professional	26	$27.47	$45.79	$72.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.93 / $77.45 / $146.40	Professional	TC	$44.93	$77.45	$146.40