Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.79 / $12.99 / $25.72	Facility	26	$11.79	$12.99	$25.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.67 / $108.70 / $301.85	Professional		$71.67	$108.70	$301.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $12.99 / $32.77	Professional	26	$11.14	$12.99	$32.77
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $36.99 / $40.75 / $229.70	Professional	52	$36.99	$40.75	$229.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.51 / $80.78 / $157.96	Professional	TC	$63.51	$80.78	$157.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.53 / $60.62 / $60.67	Professional		$48.53	$60.62	$60.67
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.92 / $10.76 / $19.48	Professional	26	$8.92	$10.76	$19.48
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $54.56 / $54.56 / $54.56	Professional	TC	$54.56	$54.56	$54.56
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $78.48 / $128.24 / $208.32	Professional		$78.48	$128.24	$208.32
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $11.74 / $19.51 / $29.47	Professional	26	$11.74	$19.51	$29.47
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $66.75 / $108.73 / $183.26	Professional	TC	$66.75	$108.73	$183.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.54 / $13.54	Facility	26	$13.54	$13.54	$13.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.95 / $123.87 / $195.08	Professional		$75.95	$123.87	$195.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.08 / $15.21 / $25.39	Professional	26	$11.08	$15.21	$25.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.12 / $108.12 / $174.04	Professional	TC	$66.12	$108.12	$174.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $101.61 / $128.85 / $260.74	Professional		$101.61	$128.85	$260.74
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.20 / $17.85 / $36.11	Professional	26	$14.20	$17.85	$36.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $86.83 / $110.99 / $224.60	Professional	TC	$86.83	$110.99	$224.60
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.67 / $13.16 / $21.16	Professional	26	$11.67	$13.16	$21.16
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $11.78 / $15.92 / $40.40	Facility	26	$11.78	$15.92	$40.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $74.18 / $115.56 / $301.85	Professional		$74.18	$115.56	$301.85
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $11.33 / $15.93 / $32.52	Professional	26	$11.33	$15.93	$32.52
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $35.28 / $43.01 / $285.48	Professional	52	$35.28	$43.01	$285.48
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $64.50 / $97.21 / $180.24	Professional	TC	$64.50	$97.21	$180.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.48 / $80.30 / $176.70	Professional		$17.48	$80.30	$176.70
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.54 / $13.54	Facility	26	$13.54	$13.54	$13.54
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $75.06 / $121.89 / $195.08	Professional		$75.06	$121.89	$195.08
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.08 / $15.21 / $26.88	Professional	26	$11.08	$15.21	$26.88
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.12 / $107.05 / $176.25	Professional	TC	$66.12	$107.05	$176.25
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $11.91 / $11.91 / $20.00	Facility	26	$11.91	$11.91	$20.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $77.08 / $78.29 / $119.50	Professional		$77.08	$78.29	$119.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.45 / $12.08 / $20.00	Professional	26	$11.45	$12.08	$20.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $65.00 / $66.38 / $99.50	Professional	TC	$65.00	$66.38	$99.50
United Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $99.75 / $174.91	Professional		$75.02	$99.75	$174.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $14.47 / $24.44	Professional	26	$11.07	$14.47	$24.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.12 / $94.12 / $149.16	Professional	TC	$66.12	$94.12	$149.16