Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.25 / $9.61 / $20.13	Facility	26	$7.25	$9.61	$20.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $14.35 / $52.90 / $188.06	Facility	TC	$14.35	$52.90	$188.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.71 / $23.51 / $57.19	Professional		$17.71	$23.51	$57.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.33 / $7.65 / $28.64	Professional	26	$6.33	$7.65	$28.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $11.78 / $14.78 / $27.44	Professional	TC	$11.78	$14.78	$27.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.05 / $16.87 / $21.57	Professional		$13.05	$16.87	$21.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.72 / $8.16 / $12.19	Professional	26	$5.72	$8.16	$12.19
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $67.23 / $89.78 / $119.68	Facility	TC	$67.23	$89.78	$119.68
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $21.03 / $32.82 / $43.11	Professional		$21.03	$32.82	$43.11
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $7.37 / $11.94 / $17.73	Professional	26	$7.37	$11.94	$17.73
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $42.06 / $65.61 / $86.15	Professional	50	$42.06	$65.61	$86.15
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $13.66 / $22.26 / $29.59	Professional	TC	$13.66	$22.26	$29.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $8.46 / $8.46	Facility	26	$8.46	$8.46	$8.46
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $16.03 / $16.03 / $16.03	Facility	TC	$16.03	$16.03	$16.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.37 / $28.42 / $43.66	Professional		$17.37	$28.42	$43.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.72 / $9.02 / $14.55	Professional	26	$5.72	$9.02	$14.55
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $31.05 / $35.06 / $35.06	Professional	50	$31.05	$35.06	$35.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.51 / $19.20 / $29.62	Professional	TC	$11.51	$19.20	$29.62
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $24.51 / $30.04 / $37.44	Professional		$24.51	$30.04	$37.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $9.71 / $15.25	Professional	26	$8.11	$9.71	$15.25
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $16.41 / $20.32 / $28.89	Professional	TC	$16.41	$20.32	$28.89
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $115.15 / $148.93 / $482.71	Facility	TC	$115.15	$148.93	$482.71
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.57 / $23.87 / $26.27	Professional		$22.57	$23.87	$26.27
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.86 / $8.58 / $13.57	Professional	26	$7.86	$8.58	$13.57
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $7.25 / $10.49 / $23.20	Facility	26	$7.25	$10.49	$23.20
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $15.77 / $46.46 / $256.89	Facility	TC	$15.77	$46.46	$256.89
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $17.96 / $25.56 / $59.24	Professional		$17.96	$25.56	$59.24
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $6.44 / $9.38 / $21.53	Professional	26	$6.44	$9.38	$21.53
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $12.13 / $17.00 / $38.04	Professional	TC	$12.13	$17.00	$38.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.83 / $20.17 / $39.39	Professional		$7.83	$20.17	$39.39
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $5.04 / $8.46 / $8.46	Facility	26	$5.04	$8.46	$8.46
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $12.36 / $16.03 / $16.03	Facility	TC	$12.36	$16.03	$16.03
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $17.43 / $28.09 / $43.66	Professional		$17.43	$28.09	$43.66
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.77 / $9.02 / $14.71	Professional	26	$5.77	$9.02	$14.71
Priority Health Facility/Professional Professional Modifier 50 Low / Median / High Price $31.05 / $35.06 / $37.46	Professional	50	$31.05	$35.06	$37.46
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.51 / $19.16 / $29.13	Professional	TC	$11.51	$19.16	$29.13
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $7.29 / $7.29 / $8.00	Facility	26	$7.29	$7.29	$8.00
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $13.59 / $13.59 / $18.50	Facility	TC	$13.59	$13.59	$18.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $20.56 / $20.87 / $26.50	Professional		$20.56	$20.87	$26.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $7.09 / $7.30 / $8.00	Professional	26	$7.09	$7.30	$8.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $13.34 / $13.59 / $18.50	Professional	TC	$13.34	$13.59	$18.50
United Facility/Professional Professional Modifier Low / Median / High Price $19.00 / $24.00 / $39.03	Professional		$19.00	$24.00	$39.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $8.74 / $14.47	Professional	26	$6.95	$8.74	$14.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.57 / $15.17 / $24.45	Professional	TC	$11.57	$15.17	$24.45