Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.08 / $15.70 / $39.02	Facility	26	$12.08	$15.70	$39.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.52 / $118.46 / $633.50	Facility	TC	$28.52	$118.46	$633.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $45.24 / $131.38	Professional		$37.04	$45.24	$131.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $15.34 / $60.53	Professional	26	$11.69	$15.34	$60.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.64 / $30.94 / $58.83	Professional	TC	$25.64	$30.94	$58.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.15 / $33.15 / $44.53	Professional		$33.15	$33.15	$44.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.18 / $10.30 / $23.85	Professional	26	$10.18	$10.30	$23.85
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $133.38 / $178.13 / $237.45	Facility	TC	$133.38	$178.13	$237.45
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $43.29 / $67.67 / $114.80	Professional		$43.29	$67.67	$114.80
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $13.41 / $22.14 / $40.34	Professional	26	$13.41	$22.14	$40.34
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $29.88 / $43.31 / $74.45	Professional	TC	$29.88	$43.31	$74.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.41 / $15.41 / $15.41	Facility	26	$15.41	$15.41	$15.41
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.04 / $35.04 / $35.04	Facility	TC	$35.04	$35.04	$35.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.47 / $57.06 / $88.70	Professional		$35.47	$57.06	$88.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.81 / $19.29 / $31.25	Professional	26	$10.81	$19.29	$31.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.08 / $38.04 / $60.58	Professional	TC	$24.08	$38.04	$60.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $50.47 / $62.16 / $74.31	Professional		$50.47	$62.16	$74.31
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.69 / $17.68 / $27.87	Professional	26	$14.69	$17.68	$27.87
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.79 / $44.49 / $63.32	Professional	TC	$35.79	$44.49	$63.32
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $197.52 / $382.80 / $1,231.41	Facility	TC	$197.52	$382.80	$1,231.41
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.20 / $51.17 / $54.14	Professional		$49.20	$51.17	$54.14
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.69 / $16.39 / $22.75	Professional	26	$14.69	$16.39	$22.75
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.08 / $17.52 / $42.97	Facility	26	$12.08	$17.52	$42.97
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $28.52 / $63.55 / $570.30	Facility	TC	$28.52	$63.55	$570.30
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $39.25 / $50.65 / $133.44	Professional		$39.25	$50.65	$133.44
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $12.08 / $17.57 / $42.77	Professional	26	$12.08	$17.57	$42.77
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.82 / $33.33 / $88.73	Professional	TC	$26.82	$33.33	$88.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $64.09 / $107.13	Professional		$30.51	$64.09	$107.13
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $11.26 / $15.41 / $15.41	Facility	26	$11.26	$15.41	$15.41
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $24.11 / $35.04 / $35.04	Facility	TC	$24.11	$35.04	$35.04
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $56.94 / $88.70	Professional		$35.72	$56.94	$88.70
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $19.29 / $31.25	Professional	26	$11.07	$19.29	$31.25
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.42 / $37.96 / $60.58	Professional	TC	$24.42	$37.96	$60.58
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $13.27 / $13.27 / $18.00	Facility	26	$13.27	$13.27	$18.00
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $29.71 / $29.71 / $34.50	Facility	TC	$29.71	$29.71	$34.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $42.35 / $42.98 / $52.50	Professional		$42.35	$42.98	$52.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.96 / $13.27 / $18.00	Professional	26	$12.96	$13.27	$18.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $29.10 / $29.71 / $34.50	Professional	TC	$29.10	$29.71	$34.50
United Facility/Professional Professional Modifier Low / Median / High Price $39.18 / $49.23 / $79.76	Professional		$39.18	$49.23	$79.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.06 / $16.69 / $27.17	Professional	26	$13.06	$16.69	$27.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.79 / $32.95 / $53.44	Professional	TC	$25.79	$32.95	$53.44