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 / $139.22	Facility	26	$42.18	$46.88	$139.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.86 / $137.46 / $214.01	Professional		$113.86	$137.46	$214.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $43.90 / $80.19	Professional	26	$40.09	$43.90	$80.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.22 / $87.86 / $139.51	Professional	TC	$72.22	$87.86	$139.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $111.22 / $130.44 / $130.44	Professional		$111.22	$130.44	$130.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.46 / $72.50 / $72.50	Professional	26	$38.46	$72.50	$72.50
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $114.45 / $118.77 / $256.05	Professional		$114.45	$118.77	$256.05
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $43.88 / $45.54 / $83.87	Professional	26	$43.88	$45.54	$83.87
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $68.53 / $73.23 / $178.59	Professional	TC	$68.53	$73.23	$178.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.38 / $50.38 / $50.38	Facility	26	$50.38	$50.38	$50.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.97 / $165.51 / $289.18	Professional		$107.97	$165.51	$289.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.40 / $57.74 / $99.82	Professional	26	$41.40	$57.74	$99.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.77 / $100.64 / $206.34	Professional	TC	$66.77	$100.64	$206.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $120.82 / $176.84 / $237.12	Professional		$120.82	$176.84	$237.12
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.06 / $63.49 / $86.13	Professional	26	$43.06	$63.49	$86.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.76 / $113.25 / $147.72	Professional	TC	$77.76	$113.25	$147.72
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.55 / $143.44 / $148.68	Professional		$140.55	$143.44	$148.68
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.06 / $52.58 / $81.20	Professional	26	$51.06	$52.58	$81.20
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $46.88 / $46.88 / $139.22	Facility	26	$46.88	$46.88	$139.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $116.12 / $145.77 / $268.81	Professional		$116.12	$145.77	$268.81
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $41.24 / $47.21 / $96.51	Professional	26	$41.24	$47.21	$96.51
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $73.11 / $98.23 / $167.66	Professional	TC	$73.11	$98.23	$167.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.76 / $114.96 / $206.46	Professional		$45.76	$114.96	$206.46
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $50.03 / $50.38 / $50.38	Facility	26	$50.03	$50.38	$50.38
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $108.46 / $166.71 / $304.29	Professional		$108.46	$166.71	$304.29
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.98 / $57.74 / $102.26	Professional	26	$41.98	$57.74	$102.26
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.77 / $103.05 / $221.52	Professional	TC	$66.77	$103.05	$221.52
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $43.42 / $43.42 / $48.50	Facility	26	$43.42	$43.42	$48.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $116.67 / $118.35 / $127.58	Professional		$116.67	$118.35	$127.58
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 $73.30 / $74.92 / $82.48	Professional	TC	$73.30	$74.92	$82.48
United Facility/Professional Professional Modifier Low / Median / High Price $107.97 / $144.66 / $249.82	Professional		$107.97	$144.66	$249.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.61 / $53.23 / $88.69	Professional	26	$38.61	$53.23	$88.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.89 / $90.66 / $157.72	Professional	TC	$63.89	$90.66	$157.72