Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.75 / $36.28 / $47.99	Facility	26	$34.75	$36.28	$47.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.31 / $98.86 / $196.14	Professional		$64.31	$98.86	$196.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.85 / $34.82 / $83.44	Professional	26	$30.85	$34.82	$83.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.03 / $65.20 / $91.82	Professional	TC	$33.03	$65.20	$91.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.27 / $101.27 / $101.27	Professional		$101.27	$101.27	$101.27
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.53 / $29.53 / $39.09	Professional	26	$29.53	$29.53	$39.09
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $84.86 / $98.25 / $101.96	Professional		$84.86	$98.25	$101.96
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $33.72 / $49.30 / $82.30	Professional	26	$33.72	$49.30	$82.30
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $21.69 / $66.95 / $105.09	Professional	TC	$21.69	$66.95	$105.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.61 / $38.61 / $38.61	Facility	26	$38.61	$38.61	$38.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.91 / $97.85 / $187.93	Professional		$55.91	$97.85	$187.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.82 / $43.54 / $75.04	Professional	26	$31.82	$43.54	$75.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.87 / $61.46 / $129.21	Professional	TC	$21.87	$61.46	$129.21
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $104.47 / $152.78 / $204.22	Professional		$104.47	$152.78	$204.22
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.35 / $49.16 / $66.56	Professional	26	$33.35	$49.16	$66.56
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $71.13 / $103.57 / $135.06	Professional	TC	$71.13	$103.57	$135.06
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.57 / $112.66 / $126.75	Professional		$39.57	$112.66	$126.75
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.29 / $42.71 / $55.15	Professional	26	$37.29	$42.71	$55.15
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $34.75 / $36.28 / $107.75	Facility	26	$34.75	$36.28	$107.75
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $64.31 / $109.06 / $342.00	Professional		$64.31	$109.06	$342.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $31.26 / $37.86 / $107.75	Professional	26	$31.26	$37.86	$107.75
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $33.03 / $69.09 / $127.53	Professional	TC	$33.03	$69.09	$127.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.57 / $87.39 / $179.40	Professional		$35.57	$87.39	$179.40
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $37.64 / $38.61 / $38.61	Facility	26	$37.64	$38.61	$38.61
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $55.82 / $98.77 / $190.32	Professional		$55.82	$98.77	$190.32
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.18 / $43.57 / $78.58	Professional	26	$32.18	$43.57	$78.58
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.98 / $63.91 / $130.34	Professional	TC	$21.98	$63.91	$130.34
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $33.36 / $33.36 / $40.38	Facility	26	$33.36	$33.36	$40.38
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $99.55 / $101.02 / $109.27	Professional		$99.55	$101.02	$109.27
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $32.54 / $33.36 / $34.79	Professional	26	$32.54	$33.36	$34.79
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $66.19 / $67.65 / $74.47	Professional	TC	$66.19	$67.65	$74.47
United Facility/Professional Professional Modifier Low / Median / High Price $51.97 / $97.32 / $180.57	Professional		$51.97	$97.32	$180.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.43 / $40.68 / $65.51	Professional	26	$30.43	$40.68	$65.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.80 / $60.13 / $112.38	Professional	TC	$20.80	$60.13	$112.38