Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.75 / $23.75 / $150.81	Facility	26	$23.75	$23.75	$150.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.85 / $50.83 / $83.01	Professional		$29.85	$50.83	$83.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.35 / $21.54 / $31.28	Professional	26	$18.35	$21.54	$31.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.31 / $30.41 / $40.96	Professional	TC	$10.31	$30.41	$40.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $93.19 / $93.19 / $93.19	Professional		$93.19	$93.19	$93.19
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $44.68 / $52.57 / $73.84	Professional		$44.68	$52.57	$73.84
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $18.05 / $21.24 / $39.70	Professional	26	$18.05	$21.24	$39.70
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $21.23 / $30.24 / $43.96	Professional	TC	$21.23	$30.24	$43.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.63 / $52.57 / $93.00	Professional		$34.63	$52.57	$93.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.87 / $26.06 / $44.08	Professional	26	$19.87	$26.06	$44.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.32 / $27.05 / $53.82	Professional	TC	$11.32	$27.05	$53.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $56.35 / $78.78 / $146.03	Professional		$56.35	$78.78	$146.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.47 / $29.59 / $54.76	Professional	26	$22.47	$29.59	$54.76
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.86 / $49.28 / $91.27	Professional	TC	$33.86	$49.28	$91.27
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $23.75 / $29.64 / $150.81	Facility	26	$23.75	$29.64	$150.81
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $30.19 / $54.28 / $128.13	Professional		$30.19	$54.28	$128.13
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $23.75 / $54.34	Professional	26	$19.55	$23.75	$54.34
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $10.47 / $31.45 / $62.66	Professional	TC	$10.47	$31.45	$62.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $36.60 / $54.00 / $148.50	Professional		$36.60	$54.00	$148.50
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $34.63 / $53.36 / $89.19	Professional		$34.63	$53.36	$89.19
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.87 / $26.85 / $46.60	Professional	26	$19.87	$26.85	$46.60
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.14 / $28.49 / $51.84	Professional	TC	$11.14	$28.49	$51.84
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $20.56 / $20.56 / $22.50	Facility	26	$20.56	$20.56	$22.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $33.50 / $51.85 / $55.79	Professional		$33.50	$51.85	$55.79
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $20.05 / $20.56 / $22.50	Professional	26	$20.05	$20.56	$22.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $11.00 / $31.29 / $34.45	Professional	TC	$11.00	$31.29	$34.45
United Facility/Professional Professional Modifier Low / Median / High Price $31.72 / $48.36 / $86.90	Professional		$31.72	$48.36	$86.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.30 / $24.58 / $41.99	Professional	26	$19.30	$24.58	$41.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.96 / $27.34 / $47.41	Professional	TC	$11.96	$27.34	$47.41