Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.36 / $67.22 / $178.88	Facility	26	$36.36	$67.22	$178.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.25 / $164.74 / $495.27	Professional		$131.25	$164.74	$495.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.64 / $62.02 / $294.44	Professional	26	$34.64	$62.02	$294.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.82 / $112.69 / $312.05	Professional	TC	$96.82	$112.69	$312.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.26 / $68.39 / $78.52	Professional	26	$39.26	$68.39	$78.52
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $168.12 / $174.46 / $314.52	Professional		$168.12	$174.46	$314.52
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $41.62 / $43.19 / $82.37	Professional	26	$41.62	$43.19	$82.37
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $126.50 / $131.27 / $232.18	Professional	TC	$126.50	$131.27	$232.18
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 $68.59 / $92.53 / $263.24	Professional		$68.59	$92.53	$263.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.20 / $30.18 / $73.98	Professional	26	$20.20	$30.18	$73.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.92 / $64.77 / $176.88	Professional	TC	$39.92	$64.77	$176.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $110.19 / $255.03 / $337.10	Professional		$110.19	$255.03	$337.10
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.42 / $57.50 / $75.23	Professional	26	$25.42	$57.50	$75.23
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.78 / $197.53 / $261.87	Professional	TC	$84.78	$197.53	$261.87
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.87 / $49.29 / $68.11	Professional	26	$42.87	$49.29	$68.11
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.95 / $53.95 / $55.30	Professional	TC	$53.95	$53.95	$55.30
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $36.36 / $76.48 / $171.44	Facility	26	$36.36	$76.48	$171.44
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $136.96 / $201.62 / $710.65	Professional		$136.96	$201.62	$710.65
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $35.04 / $68.70 / $274.61	Professional	26	$35.04	$68.70	$274.61
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $99.15 / $162.38 / $539.21	Professional	TC	$99.15	$162.38	$539.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.18 / $158.18 / $287.23	Professional		$41.18	$158.18	$287.23
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 $68.59 / $107.83 / $263.24	Professional		$68.59	$107.83	$263.24
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $36.22 / $87.44	Professional	26	$19.89	$36.22	$87.44
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.92 / $67.81 / $182.65	Professional	TC	$39.92	$67.81	$182.65
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $41.51 / $41.51 / $59.28	Facility	26	$41.51	$41.51	$59.28
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $115.28 / $172.07 / $186.75	Professional		$115.28	$172.07	$186.75
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $41.31 / $43.02 / $59.28	Professional	26	$41.31	$43.02	$59.28
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $56.00 / $130.56 / $143.72	Professional	TC	$56.00	$130.56	$143.72
United Facility/Professional Professional Modifier Low / Median / High Price $95.06 / $174.50 / $275.93	Professional		$95.06	$174.50	$275.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.98 / $44.96 / $73.41	Professional	26	$26.98	$44.96	$73.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $71.25 / $129.54 / $211.95	Professional	TC	$71.25	$129.54	$211.95