Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $85.11 / $181.97	Facility	26	$28.18	$85.11	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $66.07 / $186.21	Professional		$44.67	$66.07	$186.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.20 / $102.33	Professional	26	$22.91	$30.20	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $34.67 / $67.61	Professional	TC	$17.78	$34.67	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $57.54 / $91.20	Professional		$54.95	$57.54	$91.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $30.90 / $48.98	Professional	26	$30.90	$30.90	$48.98
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $58.88 / $89.13	Professional		$50.12	$58.88	$89.13
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $25.70 / $43.65	Professional	26	$21.88	$25.70	$43.65
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $33.11 / $47.86	Professional	TC	$26.30	$33.11	$47.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $40.74	Facility	26	$6.03	$28.18	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $64.57 / $114.82	Professional		$47.86	$64.57	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $33.11 / $54.95	Professional	26	$23.99	$33.11	$54.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $30.90 / $64.57	Professional	TC	$18.62	$30.90	$64.57
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $91.20 / $120.23	Professional		$70.79	$91.20	$120.23
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $37.15 / $48.98	Professional	26	$28.84	$37.15	$48.98
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $54.95 / $70.79	Professional	TC	$41.69	$54.95	$70.79
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $74.13 / $114.82	Professional		$50.12	$74.13	$114.82
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $33.88 / $57.54	Professional	26	$25.70	$33.88	$57.54
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $38.02 / $63.10	Professional	TC	$19.05	$38.02	$63.10
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $41.69 / $181.97	Facility	26	$28.18	$41.69	$181.97
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $72.44 / $158.49	Professional		$44.67	$72.44	$158.49
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $33.88 / $79.43	Professional	26	$22.91	$33.88	$79.43
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $38.02 / $81.28	Professional	TC	$18.20	$38.02	$81.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $81.28 / $114.82	Professional		$63.10	$81.28	$114.82
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $30.90 / $30.90	Facility	26	$25.12	$30.90	$30.90
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $52.48 / $114.82	Professional		$16.60	$52.48	$114.82
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $25.12 / $30.90	Professional	26	$24.55	$25.12	$30.90
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $33.88 / $37.15	Professional	TC	$19.05	$33.88	$37.15
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $100.00	Professional		$44.67	$58.88	$100.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.20 / $50.12	Professional	26	$22.91	$30.20	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.20 / $51.29	Professional	TC	$19.05	$30.20	$51.29