Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $28.18 / $53.70	Facility	26	$14.13	$28.18	$53.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.36 / $81.28 / $302.00	Facility	TC	$32.36	$81.28	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $47.86 / $234.42	Professional		$34.67	$47.86	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $16.60 / $74.13	Professional	26	$12.02	$16.60	$74.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.84 / $58.88	Professional	TC	$20.89	$28.84	$58.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $28.18 / $28.18	Professional	TC	$28.18	$28.18	$28.18
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $112.20 / $158.49 / $229.09	Facility	TC	$112.20	$158.49	$229.09
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $45.71 / $77.62	Professional		$44.67	$45.71	$77.62
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $15.14 / $30.90	Professional	26	$14.79	$15.14	$30.90
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $31.62 / $52.48	Professional	TC	$29.51	$31.62	$52.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.63 / $16.98 / $23.99	Facility	26	$3.63	$16.98	$23.99
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.24 / $33.88 / $47.86	Facility	TC	$7.24	$33.88	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $52.48 / $87.10	Professional		$33.11	$52.48	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $19.50 / $31.62	Professional	26	$11.22	$19.50	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $33.11 / $58.88	Professional	TC	$22.39	$33.11	$58.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $61.66 / $77.62	Professional		$47.86	$61.66	$77.62
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $19.50 / $23.99	Professional	26	$15.14	$19.50	$23.99
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $41.69 / $52.48	Professional	TC	$32.36	$41.69	$52.48
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $46.77 / $93.33	Professional		$32.36	$46.77	$93.33
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $17.38 / $31.62	Professional	26	$12.88	$17.38	$31.62
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $30.90 / $61.66	Professional	TC	$19.50	$30.90	$61.66
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $50.12 / $50.12	Facility	26	$50.12	$50.12	$50.12
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $186.21 / $316.23 / $478.63	Facility	TC	$186.21	$316.23	$478.63
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Professional		$50.12	$50.12	$50.12
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $16.22 / $21.88	Professional	26	$15.85	$16.22	$21.88
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	TC	$54.95	$54.95	$54.95
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $28.18 / $53.70	Facility	26	$14.13	$28.18	$53.70
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $32.36 / $63.10 / $302.00	Facility	TC	$32.36	$63.10	$302.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $52.48 / $114.82	Professional		$37.15	$52.48	$114.82
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $17.38 / $40.74	Professional	26	$12.88	$17.38	$40.74
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.88 / $69.18	Professional	TC	$22.91	$33.88	$69.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $54.95 / $83.18	Professional		$16.60	$54.95	$83.18
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $14.45 / $17.78	Facility	26	$14.45	$14.45	$17.78
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $26.92 / $26.92 / $30.20	Facility	TC	$26.92	$26.92	$30.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $30.20 / $77.62	Professional		$15.85	$30.20	$77.62
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $14.45 / $17.78	Professional	26	$14.13	$14.45	$17.78
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $29.51 / $33.11	Professional	TC	$26.92	$29.51	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $45.71 / $77.62	Professional		$35.48	$45.71	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.98 / $28.84	Professional	26	$12.88	$16.98	$28.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $28.84 / $50.12	Professional	TC	$22.39	$28.84	$50.12