Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.19 / $11.81 / $74.98	Facility	26	$10.19	$11.81	$74.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.16 / $10.47 / $27.19	Professional	26	$9.16	$10.47	$27.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $13.83 / $15.42 / $36.07	Professional	TC	$13.83	$15.42	$36.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.50 / $21.61 / $34.68	Professional	26	$21.50	$21.61	$34.68
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $41.74 / $41.74 / $41.74	Professional	26	$41.74	$41.74	$41.74
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $58.48 / $58.48 / $58.48	Professional	TC	$58.48	$58.48	$58.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.79 / $31.92 / $53.95	Professional	26	$23.79	$31.92	$53.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.33 / $46.66 / $79.98	Professional	TC	$33.33	$46.66	$79.98
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.94 / $35.29 / $65.23	Professional	26	$26.94	$35.29	$65.23
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $38.17 / $55.51 / $102.73	Professional	TC	$38.17	$55.51	$102.73
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $10.19 / $15.30 / $74.98	Facility	26	$10.19	$15.30	$74.98
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $9.23 / $12.08 / $37.53	Professional	26	$9.23	$12.08	$37.53
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $14.28 / $18.23 / $48.44	Professional	TC	$14.28	$18.23	$48.44
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.79 / $32.15 / $54.77	Professional	26	$23.79	$32.15	$54.77
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.33 / $46.57 / $81.30	Professional	TC	$33.33	$46.57	$81.30
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $29.00 / $29.00 / $29.00	Facility	26	$29.00	$29.00	$29.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.00 / $29.00 / $29.00	Professional	26	$29.00	$29.00	$29.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.96 / $27.69 / $42.31	Professional	26	$21.96	$27.69	$42.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.80 / $43.83 / $58.71	Professional	TC	$30.80	$43.83	$58.71