Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.54 / $50.58 / $212.28	Facility	26	$42.54	$50.58	$212.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.28 / $85.00 / $195.93	Professional		$61.28	$85.00	$195.93
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $113.88 / $113.88 / $113.88	Professional	25	$113.88	$113.88	$113.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.20 / $41.88 / $162.22	Professional	26	$34.20	$41.88	$162.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.16 / $39.78 / $62.74	Professional	TC	$22.16	$39.78	$62.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.38 / $99.26 / $129.38	Professional		$71.38	$99.26	$129.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.40 / $52.40 / $68.40	Professional	26	$52.40	$52.40	$68.40
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $66.73 / $78.52 / $116.99	Professional		$66.73	$78.52	$116.99
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $31.98 / $37.61 / $69.81	Professional	26	$31.98	$37.61	$69.81
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $31.25 / $40.90 / $57.30	Professional	TC	$31.25	$40.90	$57.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $85.66 / $149.16	Professional		$67.55	$85.66	$149.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.20 / $49.16 / $78.98	Professional	26	$35.20	$49.16	$78.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $38.20 / $70.14	Professional	TC	$23.72	$38.20	$70.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $84.17 / $116.63 / $214.95	Professional		$84.17	$116.63	$214.95
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.92 / $52.28 / $95.99	Professional	26	$39.92	$52.28	$95.99
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.24 / $64.34 / $118.97	Professional	TC	$44.24	$64.34	$118.97
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.90 / $49.19 / $50.42	Professional	26	$47.90	$49.19	$50.42
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $42.54 / $51.64 / $270.13	Facility	26	$42.54	$51.64	$270.13
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $66.62 / $94.71 / $203.36	Professional		$66.62	$94.71	$203.36
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $113.88 / $113.88 / $113.88	Professional	25	$113.88	$113.88	$113.88
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $35.10 / $48.71 / $126.34	Professional	26	$35.10	$48.71	$126.34
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $44.32 / $77.95	Professional	TC	$23.23	$44.32	$77.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $91.00 / $216.90	Professional		$56.73	$91.00	$216.90
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $85.66 / $149.16	Professional		$67.55	$85.66	$149.16
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.20 / $49.16 / $82.20	Professional	26	$35.20	$49.16	$82.20
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.72 / $39.19 / $68.14	Professional	TC	$23.72	$39.19	$68.14
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $36.19 / $36.19 / $45.50	Facility	26	$36.19	$36.19	$45.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $68.00 / $76.97 / $82.41	Professional		$68.00	$76.97	$82.41
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $35.39 / $36.19 / $45.50	Professional	26	$35.39	$36.19	$45.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.50 / $40.78 / $44.89	Professional	TC	$22.50	$40.78	$44.89
United Facility/Professional Professional Modifier Low / Median / High Price $61.83 / $76.37 / $130.63	Professional		$61.83	$76.37	$130.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.68 / $46.36 / $72.98	Professional	26	$34.68	$46.36	$72.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.11 / $35.70 / $62.64	Professional	TC	$23.11	$35.70	$62.64