Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $19.50 / $47.86	Facility	26	$11.22	$19.50	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $75.86 / $223.87	Professional		$45.71	$75.86	$223.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $21.38 / $52.48	Professional	26	$12.02	$21.38	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $51.29 / $102.33	Professional	TC	$32.36	$51.29	$102.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $41.69 / $72.44	Professional		$33.88	$41.69	$72.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.14 / $19.95	Professional	26	$10.47	$15.14	$19.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.02 / $58.88	Professional	TC	$26.92	$38.02	$58.88
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $61.66 / $112.20	Professional		$50.12	$61.66	$112.20
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $19.05 / $35.48	Professional	26	$12.59	$19.05	$35.48
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $45.71 / $75.86	Professional	TC	$37.15	$45.71	$75.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.09 / $14.45 / $20.89	Facility	26	$3.09	$14.45	$20.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $61.66 / $104.71	Professional		$40.74	$61.66	$104.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $18.20 / $30.20	Professional	26	$10.23	$18.20	$30.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $44.67 / $74.13	Professional	TC	$28.84	$44.67	$74.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $72.44 / $91.20	Professional		$56.23	$72.44	$91.20
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $16.98 / $20.89	Professional	26	$13.18	$16.98	$20.89
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $56.23 / $70.79	Professional	TC	$43.65	$56.23	$70.79
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $60.26 / $109.65	Professional		$38.90	$60.26	$109.65
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $16.98 / $30.90	Professional	26	$12.30	$16.98	$30.90
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $44.67 / $83.18	Professional	TC	$26.92	$44.67	$83.18
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $57.54 / $77.62	Professional		$13.49	$57.54	$77.62
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $14.45 / $21.38	Professional	26	$13.18	$14.45	$21.38
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $56.23 / $67.61	Professional	TC	$47.86	$56.23	$67.61
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $63.10 / $83.18	Professional		$61.66	$63.10	$83.18
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $15.49 / $20.42	Professional	26	$14.79	$15.49	$20.42
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $18.62 / $47.86	Facility	26	$11.22	$18.62	$47.86
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $69.18 / $147.91	Professional		$44.67	$69.18	$147.91
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $18.62 / $42.66	Professional	26	$11.75	$18.62	$42.66
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $50.12 / $91.20	Professional	TC	$32.36	$50.12	$91.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $63.10 / $102.33	Professional		$14.13	$63.10	$102.33
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $12.30 / $16.60	Facility	26	$12.30	$12.30	$16.60
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $34.67 / $53.70	Professional		$10.72	$34.67	$53.70
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $12.30 / $16.60	Professional	26	$12.02	$12.30	$16.60
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $37.15 / $40.74	Professional	TC	$36.31	$37.15	$40.74
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $51.29 / $85.11	Professional		$40.74	$51.29	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $14.45 / $24.55	Professional	26	$11.22	$14.45	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $37.15 / $63.10	Professional	TC	$29.51	$37.15	$63.10