Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.48 / $81.64 / $341.72	Facility	26	$68.48	$81.64	$341.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.18 / $108.68 / $256.00	Professional		$93.18	$108.68	$256.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.25 / $66.70 / $165.57	Professional	26	$56.25	$66.70	$165.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.23 / $43.36 / $77.38	Professional	TC	$30.23	$43.36	$77.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.75 / $123.87 / $126.85	Professional		$90.75	$123.87	$126.85
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $54.61 / $54.61 / $67.30	Professional	26	$54.61	$54.61	$67.30
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $90.23 / $106.15 / $168.67	Professional		$90.23	$106.15	$168.67
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $52.66 / $61.95 / $114.55	Professional	26	$52.66	$61.95	$114.55
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $37.57 / $44.20 / $61.74	Professional	TC	$37.57	$44.20	$61.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.50 / $123.79 / $208.73	Professional		$96.50	$123.79	$208.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.65 / $80.40 / $132.19	Professional	26	$57.65	$80.40	$132.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.44 / $44.20 / $79.38	Professional	TC	$31.44	$44.20	$79.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $113.53 / $155.76 / $287.33	Professional		$113.53	$155.76	$287.33
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $65.70 / $86.21 / $158.79	Professional	26	$65.70	$86.21	$158.79
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $47.81 / $69.53 / $128.51	Professional	TC	$47.81	$69.53	$128.51
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $80.23 / $80.23 / $80.39	Professional	26	$80.23	$80.23	$80.39
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $68.48 / $85.04 / $434.85	Facility	26	$68.48	$85.04	$434.85
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $96.50 / $139.59 / $300.74	Professional		$96.50	$139.59	$300.74
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.09 / $76.65 / $179.00	Professional	26	$57.09	$76.65	$179.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $31.24 / $47.69 / $92.02	Professional	TC	$31.24	$47.69	$92.02
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $82.80 / $139.69 / $284.20	Professional		$82.80	$139.69	$284.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $96.50 / $123.79 / $208.73	Professional		$96.50	$123.79	$208.73
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.65 / $80.40 / $134.54	Professional	26	$57.65	$80.40	$134.54
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.31 / $44.20 / $75.56	Professional	TC	$31.31	$44.20	$75.56
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $59.40 / $59.40 / $74.00	Facility	26	$59.40	$59.40	$74.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $103.33 / $109.98	Professional		$101.72	$103.33	$109.98
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.04 / $59.40 / $74.00	Professional	26	$58.04	$59.40	$74.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $31.00 / $43.94 / $48.37	Professional	TC	$31.00	$43.94	$48.37
United Facility/Professional Professional Modifier Low / Median / High Price $88.12 / $111.55 / $189.16	Professional		$88.12	$111.55	$189.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.74 / $71.30 / $117.98	Professional	26	$56.74	$71.30	$117.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.10 / $39.40 / $66.47	Professional	TC	$29.10	$39.40	$66.47