Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.72 / $28.72 / $182.37	Facility	26	$28.72	$28.72	$182.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.79 / $58.42 / $111.47	Professional		$43.79	$58.42	$111.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.54 / $27.51 / $75.30	Professional	26	$23.54	$27.51	$75.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.73 / $33.04 / $47.61	Professional	TC	$17.73	$33.04	$47.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.88 / $54.79 / $87.90	Professional		$50.88	$54.79	$87.90
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $50.49 / $59.40 / $89.22	Professional		$50.49	$59.40	$89.22
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $21.90 / $25.76 / $47.99	Professional	26	$21.90	$25.76	$47.99
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $26.19 / $33.64 / $47.52	Professional	TC	$26.19	$33.64	$47.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.47 / $64.38 / $108.69	Professional		$48.47	$64.38	$108.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.10 / $33.38 / $53.27	Professional	26	$24.10	$33.38	$53.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.39 / $31.30 / $58.17	Professional	TC	$19.39	$31.30	$58.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $63.67 / $88.73 / $164.18	Professional		$63.67	$88.73	$164.18
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.29 / $35.83 / $66.20	Professional	26	$27.29	$35.83	$66.20
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.38 / $52.91 / $97.96	Professional	TC	$36.38	$52.91	$97.96
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $28.72 / $35.86 / $182.37	Facility	26	$28.72	$35.86	$182.37
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $44.45 / $68.97 / $184.13	Professional		$44.45	$68.97	$184.13
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $23.91 / $31.38 / $84.87	Professional	26	$23.91	$31.38	$84.87
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $17.87 / $35.89 / $66.92	Professional	TC	$17.87	$35.89	$66.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.26 / $73.30 / $166.10	Professional		$45.26	$73.30	$166.10
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $49.16 / $64.63 / $108.69	Professional		$49.16	$64.63	$108.69
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.10 / $33.42 / $55.48	Professional	26	$24.10	$33.42	$55.48
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.03 / $32.40 / $55.65	Professional	TC	$19.03	$32.40	$55.65
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $24.87 / $24.87 / $31.00	Facility	26	$24.87	$24.87	$31.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.70 / $63.05	Professional		$50.00	$58.70	$63.05
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $24.29 / $24.87 / $31.00	Professional	26	$24.29	$24.87	$31.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.00 / $33.82 / $37.24	Professional	TC	$19.00	$33.82	$37.24
United Facility/Professional Professional Modifier Low / Median / High Price $45.17 / $57.87 / $99.33	Professional		$45.17	$57.87	$99.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.89 / $31.33 / $50.36	Professional	26	$23.89	$31.33	$50.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.21 / $30.06 / $53.51	Professional	TC	$19.21	$30.06	$53.51