Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.72 / $15.69 / $25.54	Facility	26	$11.72	$15.69	$25.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $41.11 / $166.40	Professional		$35.09	$41.11	$166.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.55 / $13.27 / $36.11	Professional	26	$10.55	$13.27	$36.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.26 / $27.51 / $65.05	Professional	TC	$23.26	$27.51	$65.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.05 / $40.82 / $74.05	Professional		$28.05	$40.82	$74.05
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.53 / $12.85 / $23.42	Professional	26	$9.53	$12.85	$23.42
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $12.93 / $14.40 / $46.90	Professional	26	$12.93	$14.40	$46.90
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $41.65 / $61.42 / $70.40	Professional		$41.65	$61.42	$70.40
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $12.41 / $20.12 / $24.88	Professional	26	$12.41	$20.12	$24.88
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $29.25 / $39.77 / $47.11	Professional	TC	$29.25	$39.77	$47.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.43 / $48.53 / $77.42	Professional		$31.43	$48.53	$77.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.24 / $15.97 / $24.67	Professional	26	$9.24	$15.97	$24.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.87 / $31.72 / $53.67	Professional	TC	$21.87	$31.72	$53.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $42.40 / $55.61 / $66.89	Professional		$42.40	$55.61	$66.89
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.58 / $16.34 / $25.78	Professional	26	$13.58	$16.34	$25.78
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.03 / $43.54 / $61.97	Professional	TC	$35.03	$43.54	$61.97
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.43 / $47.00 / $51.70	Professional		$44.43	$47.00	$51.70
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.59 / $14.56 / $52.65	Professional	26	$13.59	$14.56	$52.65
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.45 / $43.45 / $43.45	Professional	TC	$43.45	$43.45	$43.45
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $12.93 / $14.04 / $29.04	Professional	26	$12.93	$14.04	$29.04
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $11.17 / $16.19 / $38.43	Facility	26	$11.17	$16.19	$38.43
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $35.10 / $45.75 / $156.00	Professional		$35.10	$45.75	$156.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $15.69 / $36.11	Professional	26	$11.07	$15.69	$36.11
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $30.73 / $67.43	Professional	TC	$24.55	$30.73	$67.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $13.37 / $40.53 / $70.61	Professional		$13.37	$40.53	$70.61
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $14.26 / $14.26 / $14.26	Facility	26	$14.26	$14.26	$14.26
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $30.73 / $48.31 / $77.39	Professional		$30.73	$48.31	$77.39
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.36 / $15.97 / $25.09	Professional	26	$9.36	$15.97	$25.09
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.76 / $31.72 / $52.35	Professional	TC	$21.76	$31.72	$52.35
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.28 / $12.28 / $14.69	Facility	26	$12.28	$12.28	$14.69
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $40.44 / $41.04 / $44.40	Professional		$40.44	$41.04	$44.40
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.99 / $12.28 / $14.69	Professional	26	$11.99	$12.28	$14.69
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.02 / $28.76 / $31.67	Professional	TC	$26.02	$28.76	$31.67
United Facility/Professional Professional Modifier Low / Median / High Price $34.38 / $43.22 / $77.45	Professional		$34.38	$43.22	$77.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.11 / $14.92 / $24.91	Professional	26	$12.11	$14.92	$24.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.99 / $30.29 / $50.47	Professional	TC	$22.99	$30.29	$50.47