Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.08 / $18.57 / $30.89	Facility	26	$14.08	$18.57	$30.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.75 / $73.29 / $250.94	Professional		$56.75	$73.29	$250.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.86 / $16.52 / $66.40	Professional	26	$12.86	$16.52	$66.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.39 / $50.38 / $104.21	Professional	TC	$42.39	$50.38	$104.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.69 / $52.22 / $120.61	Professional		$45.69	$52.22	$120.61
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $19.92 / $26.46	Professional	26	$11.70	$19.92	$26.46
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $15.37 / $17.48 / $209.98	Professional	26	$15.37	$17.48	$209.98
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $67.84 / $97.76 / $113.47	Professional		$67.84	$97.76	$113.47
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $15.07 / $24.42 / $30.08	Professional	26	$15.07	$24.42	$30.08
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $52.76 / $72.59 / $85.94	Professional	TC	$52.76	$72.59	$85.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.59 / $78.87 / $126.90	Professional		$50.59	$78.87	$126.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.15 / $19.19 / $30.07	Professional	26	$11.15	$19.19	$30.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.84 / $57.40 / $98.26	Professional	TC	$39.84	$57.40	$98.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $68.62 / $91.21 / $110.00	Professional		$68.62	$91.21	$110.00
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.57 / $19.86 / $31.20	Professional	26	$16.57	$19.86	$31.20
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $63.16 / $78.61 / $111.96	Professional	TC	$63.16	$78.61	$111.96
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $230.44 / $230.44 / $230.44	Facility	26	$230.44	$230.44	$230.44
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.36 / $85.24 / $99.94	Professional		$75.36	$85.24	$99.94
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.52 / $17.69 / $28.29	Professional	26	$16.52	$17.69	$28.29
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.96 / $79.25 / $95.10	Professional	TC	$60.96	$79.25	$95.10
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $15.37 / $17.48 / $71.98	Professional	26	$15.37	$17.48	$71.98
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $13.57 / $19.43 / $46.86	Facility	26	$13.57	$19.43	$46.86
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $57.83 / $83.84 / $236.80	Professional		$57.83	$83.84	$236.80
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $13.57 / $19.89 / $52.02	Professional	26	$13.57	$19.89	$52.02
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $45.02 / $58.52 / $120.50	Professional	TC	$45.02	$58.52	$120.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.99 / $67.95 / $117.88	Professional		$15.99	$67.95	$117.88
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $17.32 / $17.32 / $17.32	Facility	26	$17.32	$17.32	$17.32
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $50.55 / $77.68 / $126.33	Professional		$50.55	$77.68	$126.33
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.38 / $19.32 / $30.50	Professional	26	$11.38	$19.32	$30.50
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.53 / $57.40 / $95.50	Professional	TC	$39.53	$57.40	$95.50
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.91 / $14.91 / $17.75	Facility	26	$14.91	$14.91	$17.75
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $65.01 / $67.39 / $73.26	Professional		$65.01	$67.39	$73.26
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.52 / $14.93 / $17.75	Professional	26	$14.52	$14.93	$17.75
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $47.26 / $52.47 / $57.77	Professional	TC	$47.26	$52.47	$57.77
United Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $71.27 / $121.69	Professional		$57.00	$71.27	$121.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.65 / $17.91 / $30.07	Professional	26	$14.65	$17.91	$30.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.83 / $56.01 / $91.20	Professional	TC	$42.83	$56.01	$91.20