Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.74 / $51.11 / $80.02	Professional		$38.74	$51.11	$80.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.36 / $20.46 / $31.80	Professional	26	$17.36	$20.46	$31.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $25.67 / $49.60	Professional	TC	$21.38	$25.67	$49.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.86 / $69.86 / $69.86	Professional		$69.86	$69.86	$69.86
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $43.82 / $65.06 / $109.61	Professional		$43.82	$65.06	$109.61
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $45.50 / $47.21 / $85.73	Professional		$45.50	$47.21	$85.73
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $20.38 / $21.15 / $39.79	Professional	26	$20.38	$21.15	$39.79
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $25.11 / $26.06 / $46.15	Professional	TC	$25.11	$26.06	$46.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $23.35	Facility	26	$23.35	$23.35	$23.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.61 / $60.25 / $102.82	Professional		$36.61	$60.25	$102.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.35 / $23.14 / $44.41	Professional	26	$16.35	$23.14	$44.41
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.13 / $34.03 / $59.24	Professional	TC	$20.13	$34.03	$59.24
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $54.35 / $63.08 / $94.40	Professional		$54.35	$63.08	$94.40
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.21 / $28.00 / $41.90	Professional	26	$23.21	$28.00	$41.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.15 / $35.06 / $52.47	Professional	TC	$31.15	$35.06	$52.47
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.57 / $57.06 / $62.77	Professional		$53.57	$57.06	$62.77
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $43.82 / $49.32 / $100.16	Professional		$43.82	$49.32	$100.16
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $39.00 / $53.01 / $134.60	Professional		$39.00	$53.01	$134.60
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $17.75 / $20.87 / $48.45	Professional	26	$17.75	$20.87	$48.45
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $22.16 / $27.21 / $51.63	Professional	TC	$22.16	$27.21	$51.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.60 / $51.60 / $51.60	Professional		$51.60	$51.60	$51.60
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $23.35 / $23.35 / $23.35	Facility	26	$23.35	$23.35	$23.35
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $36.47 / $57.95 / $115.96	Professional		$36.47	$57.95	$115.96
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.35 / $23.21 / $47.51	Professional	26	$16.35	$23.21	$47.51
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.13 / $32.86 / $62.50	Professional	TC	$20.13	$32.86	$62.50
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $20.19 / $20.19 / $31.00	Facility	26	$20.19	$20.19	$31.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $44.24 / $44.84 / $48.15	Professional		$44.24	$44.84	$48.15
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.76 / $20.19 / $23.44	Professional	26	$19.76	$20.19	$23.44
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.16 / $24.65 / $27.14	Professional	TC	$24.16	$24.65	$27.14
United Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $52.80 / $87.40	Professional		$38.97	$52.80	$87.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.80 / $22.01 / $39.04	Professional	26	$15.80	$22.01	$39.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.98 / $30.01 / $49.05	Professional	TC	$20.98	$30.01	$49.05