Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.75 / $25.99 / $80.83	Facility	26	$24.75	$25.99	$80.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.60 / $150.80 / $282.95	Professional		$114.60	$150.80	$282.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.80 / $23.96 / $55.58	Professional	26	$18.80	$23.96	$55.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $90.80 / $113.25 / $237.21	Professional	TC	$90.80	$113.25	$237.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.41 / $84.41 / $96.35	Professional		$84.41	$84.41	$96.35
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.91 / $17.30 / $33.68	Professional	26	$16.91	$17.30	$33.68
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $118.21 / $149.04 / $231.02	Professional		$118.21	$149.04	$231.02
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $23.18 / $28.89 / $47.32	Professional	26	$23.18	$28.89	$47.32
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $95.03 / $119.49 / $183.68	Professional	TC	$95.03	$119.49	$183.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.28 / $175.22 / $279.88	Professional		$116.28	$175.22	$279.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $28.03 / $46.79	Professional	26	$20.23	$28.03	$46.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.05 / $152.36 / $238.55	Professional	TC	$96.05	$152.36	$238.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $104.00 / $180.19 / $245.86	Professional		$104.00	$180.19	$245.86
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.92 / $34.86 / $70.56	Professional	26	$27.92	$34.86	$70.56
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $123.71 / $157.77 / $319.26	Professional	TC	$123.71	$157.77	$319.26
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.26 / $30.05 / $447.20	Professional	26	$26.26	$30.05	$447.20
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $24.75 / $33.72 / $87.33	Facility	26	$24.75	$33.72	$87.33
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $115.57 / $185.05 / $381.00	Professional		$115.57	$185.05	$381.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $20.63 / $28.29 / $57.29	Professional	26	$20.63	$28.29	$57.29
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $92.34 / $151.46 / $305.80	Professional	TC	$92.34	$151.46	$305.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $148.80 / $280.00	Professional		$34.29	$148.80	$280.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $114.19 / $174.73 / $288.02	Professional		$114.19	$174.73	$288.02
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $28.03 / $48.18	Professional	26	$20.23	$28.03	$48.18
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $96.05 / $151.82 / $243.23	Professional	TC	$96.05	$151.82	$243.23
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $23.52 / $23.52 / $28.00	Facility	26	$23.52	$23.52	$28.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $116.92 / $118.67 / $215.00	Professional		$116.92	$118.67	$215.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.65 / $23.79 / $28.00	Professional	26	$22.65	$23.79	$28.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $93.13 / $95.15 / $187.00	Professional	TC	$93.13	$95.15	$187.00
United Facility/Professional Professional Modifier Low / Median / High Price $111.66 / $151.49 / $265.36	Professional		$111.66	$151.49	$265.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.30 / $27.62 / $49.16	Professional	26	$19.30	$27.62	$49.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.92 / $128.38 / $213.55	Professional	TC	$93.92	$128.38	$213.55