Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.17 / $20.53 / $20.53	Facility	26	$19.17	$20.53	$20.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $49.69 / $152.47	Professional		$32.34	$49.69	$152.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.29 / $23.26 / $37.29	Professional	26	$18.29	$23.26	$37.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $19.70 / $97.42	Professional	TC	$14.45	$19.70	$97.42
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $37.86 / $39.29 / $71.04	Professional		$37.86	$39.29	$71.04
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $21.02 / $34.10 / $81.94	Professional	26	$21.02	$34.10	$81.94
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $37.86 / $59.58 / $230.82	Professional	50	$37.86	$59.58	$230.82
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $16.84 / $24.50 / $168.44	Professional	TC	$16.84	$24.50	$168.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.05 / $24.05 / $24.05	Facility	26	$24.05	$24.05	$24.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.74 / $66.47 / $183.09	Professional		$33.74	$66.47	$183.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.77 / $32.45 / $55.14	Professional	26	$18.77	$32.45	$55.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.57 / $27.65 / $128.71	Professional	TC	$14.57	$27.65	$128.71
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.90 / $57.73 / $78.40	Professional		$44.90	$57.73	$78.40
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.74 / $30.52 / $43.25	Professional	26	$23.74	$30.52	$43.25
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.91 / $27.20 / $35.15	Professional	TC	$20.91	$27.20	$35.15
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $20.53 / $20.53 / $20.53	Facility	26	$20.53	$20.53	$20.53
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $34.36 / $53.93 / $188.29	Professional		$34.36	$53.93	$188.29
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $19.17 / $25.19 / $53.99	Professional	26	$19.17	$25.19	$53.99
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $15.19 / $23.77 / $111.41	Professional	TC	$15.19	$23.77	$111.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $25.30 / $52.08 / $107.50	Professional		$25.30	$52.08	$107.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $24.05 / $24.05 / $36.31	Facility	26	$24.05	$24.05	$36.31
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $31.79 / $62.14 / $179.31	Professional		$31.79	$62.14	$179.31
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.05 / $32.07 / $55.95	Professional	26	$17.05	$32.07	$55.95
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.09 / $27.48 / $129.72	Professional	TC	$14.09	$27.48	$129.72
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $20.82 / $20.82 / $35.71	Facility	26	$20.82	$20.82	$35.71
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $37.01 / $37.57 / $129.12	Professional		$37.01	$37.57	$129.12
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $20.39 / $20.82 / $35.71	Professional	26	$20.39	$20.82	$35.71
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $16.43 / $16.75 / $93.41	Professional	TC	$16.43	$16.75	$93.41
United Facility/Professional Professional Modifier Low / Median / High Price $36.83 / $48.48 / $140.99	Professional		$36.83	$48.48	$140.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.11 / $27.78 / $43.87	Professional	26	$21.11	$27.78	$43.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.90 / $20.04 / $102.04	Professional	TC	$15.90	$20.04	$102.04