Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.32 / $59.50 / $140.66	Facility	26	$30.32	$59.50	$140.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.29 / $107.77 / $467.20	Professional		$86.29	$107.77	$467.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.42 / $30.32 / $140.22	Professional	26	$23.42	$30.32	$140.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.86 / $80.53 / $289.63	Professional	TC	$62.86	$80.53	$289.63
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $46.56 / $54.05 / $62.08	Professional	26	$46.56	$54.05	$62.08
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $124.75 / $170.82 / $231.56	Professional		$124.75	$170.82	$231.56
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $32.90 / $49.53 / $65.18	Professional	26	$32.90	$49.53	$65.18
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $91.86 / $121.25 / $166.38	Professional	TC	$91.86	$121.25	$166.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $101.53 / $101.53 / $101.53	Facility	26	$101.53	$101.53	$101.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.96 / $73.16 / $179.78	Professional		$44.96	$73.16	$179.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.62 / $18.35 / $45.21	Professional	26	$12.62	$18.35	$45.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.61 / $52.89 / $127.49	Professional	TC	$32.61	$52.89	$127.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $81.63 / $188.88 / $249.48	Professional		$81.63	$188.88	$249.48
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.09 / $45.40 / $59.50	Professional	26	$20.09	$45.40	$59.50
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $61.55 / $143.46 / $189.97	Professional	TC	$61.55	$143.46	$189.97
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.32 / $35.25 / $47.33	Professional	26	$33.32	$35.25	$47.33
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.86 / $80.86 / $82.88	Professional	TC	$80.86	$80.86	$82.88
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $30.32 / $59.73 / $135.79	Facility	26	$30.32	$59.73	$135.79
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $93.98 / $154.86 / $537.92	Professional		$93.98	$154.86	$537.92
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $25.47 / $49.84 / $138.77	Professional	26	$25.47	$49.84	$138.77
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $69.06 / $118.00 / $402.14	Professional	TC	$69.06	$118.00	$402.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.46 / $117.99 / $214.17	Professional		$32.46	$117.99	$214.17
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $101.53 / $101.53 / $101.53	Facility	26	$101.53	$101.53	$101.53
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $45.54 / $87.43 / $181.50	Professional		$45.54	$87.43	$181.50
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.62 / $22.01 / $49.18	Professional	26	$12.62	$22.01	$49.18
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.56 / $60.40 / $135.94	Professional	TC	$32.56	$60.40	$135.94
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $29.27 / $32.88 / $32.88	Facility	26	$29.27	$32.88	$32.88
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $100.90 / $130.25 / $141.26	Professional		$100.90	$130.25	$141.26
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.27 / $32.88 / $34.07	Professional	26	$29.27	$32.88	$34.07
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $71.63 / $97.37 / $107.19	Professional	TC	$71.63	$97.37	$107.19
United Facility/Professional Professional Modifier Low / Median / High Price $73.23 / $133.15 / $215.37	Professional		$73.23	$133.15	$215.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.48 / $35.42 / $56.80	Professional	26	$19.48	$35.42	$56.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.44 / $97.73 / $157.65	Professional	TC	$49.44	$97.73	$157.65