Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.18 / $46.88 / $46.88	Facility	26	$42.18	$46.88	$46.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.45 / $83.40 / $101.21	Professional		$74.45	$83.40	$101.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.81 / $43.07 / $62.35	Professional	26	$38.81	$43.07	$62.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.78 / $41.09 / $52.87	Professional	TC	$33.78	$41.09	$52.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.41 / $94.86 / $94.86	Professional		$81.41	$94.86	$94.86
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $74.59 / $87.76 / $148.44	Professional		$74.59	$87.76	$148.44
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $43.57 / $45.21 / $82.60	Professional	26	$43.57	$45.21	$82.60
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $36.17 / $42.55 / $72.00	Professional	TC	$36.17	$42.55	$72.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	26	$50.00	$50.00	$50.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.94 / $102.27 / $179.05	Professional		$68.94	$102.27	$179.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.10 / $55.93 / $98.19	Professional	26	$41.10	$55.93	$98.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.42 / $45.92 / $81.26	Professional	TC	$25.42	$45.92	$81.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $87.77 / $128.76 / $173.13	Professional		$87.77	$128.76	$173.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $42.50 / $62.87 / $85.35	Professional	26	$42.50	$62.87	$85.35
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.27 / $65.89 / $85.78	Professional	TC	$45.27	$65.89	$85.78
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.45 / $65.98 / $82.20	Professional	26	$64.45	$65.98	$82.20
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $46.88 / $46.88 / $46.88	Facility	26	$46.88	$46.88	$46.88
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $75.52 / $86.17 / $122.79	Professional		$75.52	$86.17	$122.79
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $40.11 / $45.28 / $83.02	Professional	26	$40.11	$45.28	$83.02
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $34.88 / $41.94 / $63.20	Professional	TC	$34.88	$41.94	$63.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.77 / $75.13 / $153.08	Professional		$42.77	$75.13	$153.08
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $47.59 / $50.00 / $50.00	Facility	26	$47.59	$50.00	$50.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $69.03 / $102.27 / $199.16	Professional		$69.03	$102.27	$199.16
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.67 / $56.54 / $101.52	Professional	26	$41.67	$56.54	$101.52
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.69 / $49.17 / $99.57	Professional	TC	$26.69	$49.17	$99.57
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $43.42 / $43.42 / $47.50	Facility	26	$43.42	$43.42	$47.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $83.23 / $84.52 / $90.34	Professional		$83.23	$84.52	$90.34
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.38 / $43.42 / $45.10	Professional	26	$42.38	$43.42	$45.10
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $40.22 / $41.09 / $45.24	Professional	TC	$40.22	$41.09	$45.24
United Facility/Professional Professional Modifier Low / Median / High Price $64.87 / $92.68 / $165.69	Professional		$64.87	$92.68	$165.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.58 / $52.44 / $87.36	Professional	26	$39.58	$52.44	$87.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.41 / $41.14 / $76.13	Professional	TC	$23.41	$41.14	$76.13