Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.95 / $18.34 / $42.91	Facility	26	$13.95	$18.34	$42.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.52 / $58.74 / $364.44	Facility	TC	$28.52	$58.74	$364.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.88 / $42.98 / $182.40	Professional		$36.88	$42.98	$182.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.57 / $14.49 / $28.61	Professional	26	$12.57	$14.49	$28.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $27.67 / $40.58	Professional	TC	$23.51	$27.67	$40.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.38 / $43.38 / $43.38	Professional		$43.38	$43.38	$43.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $11.32 / $21.37	Professional	26	$11.07	$11.32	$21.37
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $112.98 / $150.87 / $201.12	Facility	TC	$112.98	$150.87	$201.12
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $44.32 / $65.31 / $76.53	Professional		$44.32	$65.31	$76.53
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $14.76 / $23.93 / $30.56	Professional	26	$14.76	$23.93	$30.56
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $29.56 / $39.77 / $49.19	Professional	TC	$29.56	$39.77	$49.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Facility	26	$16.60	$16.60	$16.60
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 $33.29 / $52.58 / $83.96	Professional		$33.29	$52.58	$83.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.06 / $19.14 / $29.82	Professional	26	$11.06	$19.14	$29.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.23 / $32.35 / $54.65	Professional	TC	$22.23	$32.35	$54.65
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.79 / $58.97 / $70.79	Professional		$45.79	$58.97	$70.79
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.14 / $19.44 / $30.69	Professional	26	$16.14	$19.44	$30.69
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.40 / $44.01 / $62.66	Professional	TC	$35.40	$44.01	$62.66
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $314.33 / $314.33 / $775.32	Facility	TC	$314.33	$314.33	$775.32
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.93 / $16.16 / $20.75	Professional	26	$14.93	$16.16	$20.75
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $13.95 / $19.27 / $45.66	Facility	26	$13.95	$19.27	$45.66
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $28.52 / $49.90 / $514.77	Facility	TC	$28.52	$49.90	$514.77
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $38.03 / $46.54 / $138.22	Professional		$38.03	$46.54	$138.22
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $13.16 / $16.32 / $36.77	Professional	26	$13.16	$16.32	$36.77
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $25.29 / $32.10 / $63.42	Professional	TC	$25.29	$32.10	$63.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.67 / $41.87 / $74.23	Professional		$15.67	$41.87	$74.23
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $16.60 / $16.60 / $16.60	Facility	26	$16.60	$16.60	$16.60
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $35.04 / $35.04 / $35.04	Facility	TC	$35.04	$35.04	$35.04
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $33.45 / $52.41 / $83.96	Professional		$33.45	$52.41	$83.96
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.14 / $19.41 / $30.36	Professional	26	$11.14	$19.41	$30.36
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.71 / $32.33 / $54.65	Professional	TC	$22.71	$32.33	$54.65
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.61 / $14.61 / $17.75	Facility	26	$14.61	$14.61	$17.75
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $26.73 / $30.03 / $30.03	Facility	TC	$26.73	$30.03	$30.03
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $43.98 / $44.63 / $48.20	Professional		$43.98	$44.63	$48.20
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.27 / $14.61 / $17.75	Professional	26	$14.27	$14.61	$17.75
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.73 / $30.03 / $33.06	Professional	TC	$26.73	$30.03	$33.06
United Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $47.32 / $81.14	Professional		$38.65	$47.32	$81.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.62 / $17.35 / $30.29	Professional	26	$14.62	$17.35	$30.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.35 / $30.03 / $51.04	Professional	TC	$24.35	$30.03	$51.04