Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.05 / $13.73 / $26.90	Facility	26	$12.05	$13.73	$26.90
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.70 / $74.66 / $197.34	Facility	TC	$26.70	$74.66	$197.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.84 / $40.11 / $86.07	Professional		$34.84	$40.11	$86.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.84 / $12.67 / $26.01	Professional	26	$10.84	$12.67	$26.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.26 / $26.27 / $43.76	Professional	TC	$21.26	$26.27	$43.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.88 / $39.88 / $39.88	Professional		$39.88	$39.88	$39.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.80 / $10.03 / $13.55	Professional	26	$9.80	$10.03	$13.55
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $109.82 / $146.65 / $195.49	Facility	TC	$109.82	$146.65	$195.49
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $40.72 / $60.21 / $71.30	Professional		$40.72	$60.21	$71.30
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $13.07 / $21.18 / $26.57	Professional	26	$13.07	$21.18	$26.57
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $27.66 / $38.19 / $46.02	Professional	TC	$27.66	$38.19	$46.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.53 / $48.77 / $77.43	Professional		$30.53	$48.77	$77.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $16.84 / $25.93	Professional	26	$9.63	$16.84	$25.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.05 / $31.23 / $52.22	Professional	TC	$21.05	$31.23	$52.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $42.77 / $54.28 / $65.25	Professional		$42.77	$54.28	$65.25
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.32 / $17.25 / $27.17	Professional	26	$14.32	$17.25	$27.17
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.13 / $41.18 / $58.61	Professional	TC	$33.13	$41.18	$58.61
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $71.55 / $71.55 / $697.78	Facility	TC	$71.55	$71.55	$697.78
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.63 / $50.91 / $51.30	Professional		$46.63	$50.91	$51.30
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.32 / $14.90 / $16.20	Professional	26	$14.32	$14.90	$16.20
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.05 / $16.64 / $39.94	Facility	26	$12.05	$16.64	$39.94
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $26.70 / $51.14 / $197.34	Facility	TC	$26.70	$51.14	$197.34
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $34.84 / $42.53 / $106.30	Professional		$34.84	$42.53	$106.30
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $11.23 / $14.15 / $29.01	Professional	26	$11.23	$14.15	$29.01
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $23.43 / $30.05 / $54.42	Professional	TC	$23.43	$30.05	$54.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.20 / $38.69 / $68.26	Professional		$13.20	$38.69	$68.26
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.00 / $15.00 / $15.00	Facility	26	$15.00	$15.00	$15.00
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $32.79 / $32.79 / $32.79	Facility	TC	$32.79	$32.79	$32.79
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $30.74 / $48.60 / $76.75	Professional		$30.74	$48.60	$76.75
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.71 / $16.88 / $25.93	Professional	26	$9.71	$16.88	$25.93
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.05 / $31.12 / $50.94	Professional	TC	$21.05	$31.12	$50.94
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.93 / $12.93 / $15.44	Facility	26	$12.93	$12.93	$15.44
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $25.98 / $27.81 / $27.81	Facility	TC	$25.98	$27.81	$27.81
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $40.15 / $40.75 / $44.05	Professional		$40.15	$40.75	$44.05
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.63 / $12.93 / $15.44	Professional	26	$12.63	$12.93	$15.44
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $25.98 / $27.81 / $30.62	Professional	TC	$25.98	$27.81	$30.62
United Facility/Professional Professional Modifier Low / Median / High Price $35.57 / $43.89 / $75.34	Professional		$35.57	$43.89	$75.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.43 / $15.48 / $26.26	Professional	26	$12.43	$15.48	$26.26
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $29.96 / $51.13	Professional	TC	$23.44	$29.96	$51.13