Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.15 / $75.25 / $315.12	Facility	26	$63.15	$75.25	$315.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.62 / $103.06 / $260.00	Professional		$83.62	$103.06	$260.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.87 / $62.40 / $217.00	Professional	26	$51.87	$62.40	$217.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.60 / $40.61 / $72.16	Professional	TC	$26.60	$40.61	$72.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.04 / $145.47 / $160.97	Professional		$84.04	$145.47	$160.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $50.35 / $50.35 / $103.78	Professional	26	$50.35	$50.35	$103.78
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $83.56 / $98.31 / $152.82	Professional		$83.56	$98.31	$152.82
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $48.52 / $57.08 / $104.96	Professional	26	$48.52	$57.08	$104.96
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $34.77 / $41.23 / $57.73	Professional	TC	$34.77	$41.23	$57.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.80 / $111.71 / $190.57	Professional		$87.80	$111.71	$190.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.09 / $72.56 / $116.05	Professional	26	$53.09	$72.56	$116.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.49 / $39.50 / $74.38	Professional	TC	$27.49	$39.50	$74.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $105.11 / $144.29 / $266.44	Professional		$105.11	$144.29	$266.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.51 / $79.42 / $146.52	Professional	26	$60.51	$79.42	$146.52
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.60 / $64.86 / $119.93	Professional	TC	$44.60	$64.86	$119.93
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.91 / $112.91 / $112.91	Professional		$112.91	$112.91	$112.91
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.26 / $67.22 / $95.58	Professional	26	$65.26	$67.22	$95.58
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $68.40 / $78.34 / $401.00	Facility	26	$68.40	$78.34	$401.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $88.02 / $130.47 / $260.00	Professional		$88.02	$130.47	$260.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $52.61 / $75.76 / $172.53	Professional	26	$52.61	$75.76	$172.53
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.89 / $44.93 / $86.15	Professional	TC	$26.89	$44.93	$86.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.80 / $119.50 / $263.80	Professional		$76.80	$119.50	$263.80
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $87.48 / $111.71 / $189.00	Professional		$87.48	$111.71	$189.00
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.09 / $72.64 / $122.00	Professional	26	$53.09	$72.64	$122.00
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.49 / $40.38 / $70.68	Professional	TC	$27.49	$40.38	$70.68
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $54.74 / $54.74 / $62.00	Facility	26	$54.74	$54.74	$62.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $89.50 / $95.83 / $102.03	Professional		$89.50	$95.83	$102.03
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $53.48 / $54.74 / $62.00	Professional	26	$53.48	$54.74	$62.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $27.50 / $41.09 / $45.24	Professional	TC	$27.50	$41.09	$45.24
United Facility/Professional Professional Modifier Low / Median / High Price $80.59 / $99.65 / $169.65	Professional		$80.59	$99.65	$169.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.89 / $65.84 / $108.81	Professional	26	$51.89	$65.84	$108.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.78 / $37.60 / $60.35	Professional	TC	$26.78	$37.60	$60.35