Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.22 / $15.30 / $35.70	Facility	26	$12.22	$15.30	$35.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.46 / $70.28 / $195.00	Professional		$46.46	$70.28	$195.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.76 / $16.52 / $41.65	Professional	26	$11.76	$16.52	$41.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.74 / $40.96 / $85.80	Professional	TC	$32.74	$40.96	$85.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.09 / $41.83 / $98.42	Professional		$36.09	$41.83	$98.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.03 / $14.09 / $20.39	Professional	26	$10.03	$14.09	$20.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $33.54 / $60.03 / $60.80	Professional	TC	$33.54	$60.03	$60.80
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $15.17 / $17.73 / $34.90	Professional	26	$15.17	$17.73	$34.90
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $52.16 / $73.97 / $110.14	Professional		$52.16	$73.97	$110.14
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $13.07 / $21.18 / $35.69	Professional	26	$13.07	$21.18	$35.69
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $39.09 / $50.61 / $74.45	Professional	TC	$39.09	$50.61	$74.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.79 / $61.07 / $97.76	Professional		$39.79	$61.07	$97.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.18 / $17.79 / $29.14	Professional	26	$10.18	$17.79	$29.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.39 / $43.65 / $71.87	Professional	TC	$27.39	$43.65	$71.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $61.14 / $69.94 / $84.16	Professional		$61.14	$69.94	$84.16
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 $46.82 / $58.23 / $82.92	Professional	TC	$46.82	$58.23	$82.92
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $89.21 / $89.21 / $89.21	Facility	26	$89.21	$89.21	$89.21
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.89 / $61.48 / $80.09	Professional		$55.89	$61.48	$80.09
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.95 / $15.38 / $21.77	Professional	26	$13.95	$15.38	$21.77
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.17 / $49.70 / $70.47	Professional	TC	$45.17	$49.70	$70.47
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $55.01 / $55.01 / $55.01	Professional		$55.01	$55.01	$55.01
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $16.82 / $34.90	Professional	26	$13.80	$16.82	$34.90
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $11.76 / $16.79 / $41.02	Facility	26	$11.76	$16.79	$41.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $47.71 / $71.39 / $159.72	Professional		$47.71	$71.39	$159.72
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $12.12 / $18.67 / $39.68	Professional	26	$12.12	$18.67	$39.68
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $34.09 / $47.72 / $88.84	Professional	TC	$34.09	$47.72	$88.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.88 / $52.66 / $92.10	Professional		$13.88	$52.66	$92.10
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $14.65 / $14.65	Facility	26	$10.00	$14.65	$14.65
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $39.79 / $61.07 / $96.84	Professional		$39.79	$61.07	$96.84
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.45 / $17.64 / $29.14	Professional	26	$10.45	$17.64	$29.14
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.87 / $43.81 / $69.61	Professional	TC	$28.87	$43.81	$69.61
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.93 / $12.93 / $16.50	Facility	26	$12.93	$12.93	$16.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $50.36 / $51.18 / $55.53	Professional		$50.36	$51.18	$55.53
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.63 / $12.93 / $16.50	Professional	26	$12.63	$12.93	$16.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.89 / $38.25 / $42.11	Professional	TC	$34.89	$38.25	$42.11
United Facility/Professional Professional Modifier Low / Median / High Price $43.79 / $54.13 / $94.68	Professional		$43.79	$54.13	$94.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.43 / $15.48 / $27.27	Professional	26	$12.43	$15.48	$27.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.36 / $40.90 / $68.78	Professional	TC	$31.36	$40.90	$68.78