Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.27 / $20.27 / $128.72	Facility	26	$20.27	$20.27	$128.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.79 / $47.66 / $92.09	Professional		$37.79	$47.66	$92.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.79 / $21.07 / $35.35	Professional	26	$16.79	$21.07	$35.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.44 / $29.67 / $45.70	Professional	TC	$16.44	$29.67	$45.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.82 / $43.82 / $61.05	Professional		$43.82	$43.82	$61.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.23 / $25.23 / $25.23	Professional	26	$25.23	$25.23	$25.23
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $41.19 / $48.46 / $72.84	Professional		$41.19	$48.46	$72.84
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $15.40 / $18.12 / $34.69	Professional	26	$15.40	$18.12	$34.69
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $23.24 / $30.35 / $42.63	Professional	TC	$23.24	$30.35	$42.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $52.98 / $93.18	Professional		$41.85	$52.98	$93.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.94 / $25.78 / $39.52	Professional	26	$16.94	$25.78	$39.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.70 / $28.24 / $52.19	Professional	TC	$17.70	$28.24	$52.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.02 / $72.90 / $134.66	Professional		$52.02	$72.90	$134.66
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.22 / $25.18 / $46.25	Professional	26	$19.22	$25.18	$46.25
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $47.72 / $88.41	Professional	TC	$32.79	$47.72	$88.41
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $20.27 / $25.37 / $128.72	Facility	26	$20.27	$25.37	$128.72
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $38.36 / $59.64 / $114.59	Professional		$38.36	$59.64	$114.59
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $16.91 / $23.78 / $53.66	Professional	26	$16.91	$23.78	$53.66
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $16.44 / $31.76 / $57.87	Professional	TC	$16.44	$31.76	$57.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $63.70 / $137.19	Professional		$33.88	$63.70	$137.19
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $52.98 / $92.61	Professional		$41.85	$52.98	$92.61
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.94 / $25.71 / $41.85	Professional	26	$16.94	$25.71	$41.85
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.46 / $29.01 / $50.20	Professional	TC	$17.46	$29.01	$50.20
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $17.59 / $17.59 / $25.50	Facility	26	$17.59	$17.59	$25.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $42.65 / $47.93 / $51.65	Professional		$42.65	$47.93	$51.65
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $17.20 / $17.59 / $25.50	Professional	26	$17.20	$17.59	$25.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $30.34 / $33.40	Professional	TC	$17.14	$30.34	$33.40
United Facility/Professional Professional Modifier Low / Median / High Price $37.82 / $47.13 / $79.03	Professional		$37.82	$47.13	$79.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.47 / $22.61 / $35.94	Professional	26	$16.47	$22.61	$35.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.30 / $26.20 / $45.88	Professional	TC	$17.30	$26.20	$45.88