Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.47 / $16.04 / $41.96	Facility	26	$13.47	$16.04	$41.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.91 / $75.19 / $298.56	Professional		$52.91	$75.19	$298.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.73 / $17.52 / $46.96	Professional	26	$12.73	$17.52	$46.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.75 / $51.21 / $109.93	Professional	TC	$38.75	$51.21	$109.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $48.13 / $61.36	Professional		$39.93	$48.13	$61.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.18 / $20.85 / $24.40	Professional	26	$11.18	$20.85	$24.40
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $68.33 / $69.20 / $69.20	Professional	TC	$68.33	$69.20	$69.20
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $68.73 / $84.72 / $387.23	Professional		$68.73	$84.72	$387.23
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $59.23 / $88.16 / $110.22	Professional		$59.23	$88.16	$110.22
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $14.73 / $23.87 / $42.30	Professional	26	$14.73	$23.87	$42.30
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $44.50 / $66.31 / $81.86	Professional	TC	$44.50	$66.31	$81.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.57 / $16.57 / $16.57	Facility	26	$16.57	$16.57	$16.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.88 / $77.84 / $125.66	Professional		$48.88	$77.84	$125.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.82 / $20.42 / $31.38	Professional	26	$11.82	$20.42	$31.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.10 / $57.23 / $91.52	Professional	TC	$36.10	$57.23	$91.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $71.94 / $85.71 / $101.32	Professional		$71.94	$85.71	$101.32
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $19.43 / $30.49	Professional	26	$16.22	$19.43	$30.49
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $53.28 / $66.29 / $94.40	Professional	TC	$53.28	$66.29	$94.40
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.87 / $70.26 / $78.06	Professional		$63.87	$70.26	$78.06
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.79 / $17.63 / $27.04	Professional	26	$15.79	$17.63	$27.04
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $66.00 / $80.22 / $80.78	Professional	TC	$66.00	$80.22	$80.78
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $68.56 / $80.38 / $143.22	Professional		$68.56	$80.38	$143.22
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.98 / $18.51 / $45.22	Facility	26	$12.98	$18.51	$45.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $54.04 / $77.48 / $197.65	Professional		$54.04	$77.48	$197.65
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $12.98 / $19.32 / $46.39	Professional	26	$12.98	$19.32	$46.39
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $41.04 / $57.99 / $125.48	Professional	TC	$41.04	$57.99	$125.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.64 / $61.70 / $104.82	Professional		$15.64	$61.70	$104.82
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $11.98 / $16.57 / $16.57	Facility	26	$11.98	$16.57	$16.57
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $48.88 / $76.92 / $126.97	Professional		$48.88	$76.92	$126.97
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.88 / $20.25 / $31.38	Professional	26	$11.88	$20.25	$31.38
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.40 / $56.67 / $93.26	Professional	TC	$36.40	$56.67	$93.26
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.57 / $14.57 / $19.50	Facility	26	$14.57	$14.57	$19.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $58.53 / $59.46 / $69.09	Professional		$58.53	$59.46	$69.09
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.19 / $14.60 / $19.50	Professional	26	$14.19	$14.60	$19.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $43.94 / $44.89 / $49.60	Professional	TC	$43.94	$44.89	$49.60
United Facility/Professional Professional Modifier Low / Median / High Price $52.01 / $65.75 / $111.39	Professional		$52.01	$65.75	$111.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.71 / $17.20 / $30.07	Professional	26	$13.71	$17.20	$30.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.19 / $50.30 / $83.44	Professional	TC	$38.19	$50.30	$83.44