Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.40 / $49.21 / $262.89	Facility	26	$41.40	$49.21	$262.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.28 / $72.65 / $153.05	Professional		$65.28	$72.65	$153.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.15 / $43.26 / $101.65	Professional	26	$34.15	$43.26	$101.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.76 / $34.50 / $61.17	Professional	TC	$21.76	$34.50	$61.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $61.49 / $61.49 / $61.49	Professional		$61.49	$61.49	$61.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $31.36 / $31.36 / $31.36	Professional	26	$31.36	$31.36	$31.36
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $61.09 / $71.87 / $115.60	Professional		$61.09	$71.87	$115.60
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $31.37 / $36.90 / $72.77	Professional	26	$31.37	$36.90	$72.77
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $29.30 / $34.96 / $48.85	Professional	TC	$29.30	$34.96	$48.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.25 / $85.36 / $149.55	Professional		$66.25	$85.36	$149.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.53 / $50.31 / $83.58	Professional	26	$34.53	$50.31	$83.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.14 / $33.63 / $62.93	Professional	TC	$23.14	$33.63	$62.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $76.89 / $106.27 / $196.63	Professional		$76.89	$106.27	$196.63
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.09 / $51.30 / $94.86	Professional	26	$39.09	$51.30	$94.86
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.81 / $54.99 / $101.77	Professional	TC	$37.81	$54.99	$101.77
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.72 / $49.72 / $61.54	Professional	26	$49.72	$49.72	$61.54
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $41.40 / $62.97 / $262.89	Facility	26	$41.40	$62.97	$262.89
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $66.13 / $84.05 / $196.93	Professional		$66.13	$84.05	$196.93
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $34.40 / $49.50 / $123.37	Professional	26	$34.40	$49.50	$123.37
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $37.29 / $73.23	Professional	TC	$22.57	$37.29	$73.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.28 / $91.50 / $196.60	Professional		$53.28	$91.50	$196.60
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $66.25 / $85.40 / $149.55	Professional		$66.25	$85.40	$149.55
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.53 / $49.84 / $83.58	Professional	26	$34.53	$49.84	$83.58
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.14 / $33.96 / $59.80	Professional	TC	$23.14	$33.96	$59.80
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $35.81 / $35.81 / $51.90	Facility	26	$35.81	$35.81	$51.90
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $69.45 / $70.58 / $84.04	Professional		$69.45	$70.58	$84.04
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $34.90 / $35.82 / $51.90	Professional	26	$34.90	$35.82	$51.90
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $32.14 / $34.77 / $38.28	Professional	TC	$32.14	$34.77	$38.28
United Facility/Professional Professional Modifier Low / Median / High Price $58.37 / $71.87 / $124.76	Professional		$58.37	$71.87	$124.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $45.87 / $71.00	Professional	26	$34.04	$45.87	$71.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.89 / $31.12 / $52.18	Professional	TC	$21.89	$31.12	$52.18