Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.23 / $7.81 / $16.10	Facility	26	$6.23	$7.81	$16.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.17 / $111.99 / $278.64	Facility	TC	$35.17	$111.99	$278.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $43.29 / $155.41	Professional		$15.14	$43.29	$155.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.83 / $10.27 / $32.00	Professional	26	$5.83	$10.27	$32.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.58 / $143.86 / $143.86	Professional	50	$69.58	$143.86	$143.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.24 / $17.48 / $24.18	Professional	52	$12.24	$17.48	$24.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $30.94 / $65.05	Professional	TC	$22.57	$30.94	$65.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.89 / $28.47 / $69.58	Professional		$24.89	$28.47	$69.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.08 / $6.93 / $11.10	Professional	26	$5.08	$6.93	$11.10
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $33.54 / $33.54	Professional	TC	$23.23	$33.54	$33.54
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $42.79 / $48.53 / $376.33	Professional		$42.79	$48.53	$376.33
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $10.40 / $101.99	Professional	26	$7.75	$10.40	$101.99
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $92.06 / $122.93 / $163.87	Facility	TC	$92.06	$122.93	$163.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $36.88 / $49.65 / $59.49	Professional		$36.88	$49.65	$59.49
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $6.68 / $10.83 / $15.50	Professional	26	$6.68	$10.83	$15.50
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $73.75 / $99.26 / $118.99	Professional	50	$73.75	$99.26	$118.99
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $34.14 / $48.67	Professional	TC	$30.20	$34.14	$48.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.66 / $7.66 / $7.66	Facility	26	$7.66	$7.66	$7.66
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $35.40 / $35.40 / $35.40	Facility	TC	$35.40	$35.40	$35.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.80 / $39.13 / $67.94	Professional		$24.80	$39.13	$67.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.04 / $8.08 / $13.14	Professional	26	$5.04	$8.08	$13.14
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.71 / $49.70 / $49.70	Professional	50	$43.71	$49.70	$49.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.91 / $30.36 / $54.56	Professional	TC	$17.91	$30.36	$54.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $32.56 / $49.83 / $60.29	Professional		$32.56	$49.83	$60.29
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.40 / $8.85 / $13.82	Professional	26	$7.40	$8.85	$13.82
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.17 / $44.96 / $64.00	Professional	TC	$36.17	$44.96	$64.00
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $128.00 / $231.11 / $378.90	Facility	TC	$128.00	$231.11	$378.90
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.85 / $45.19 / $53.69	Professional		$24.85	$45.19	$53.69
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.34 / $8.08 / $11.45	Professional	26	$7.34	$8.08	$11.45
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $16.14 / $87.83 / $97.56	Professional	50	$16.14	$87.83	$97.56
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.36 / $38.38 / $45.35	Professional	TC	$38.36	$38.38	$45.35
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $39.13 / $47.14 / $73.08	Professional		$39.13	$47.14	$73.08
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $7.54 / $9.14 / $99.81	Professional	26	$7.54	$9.14	$99.81
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $6.00 / $8.44 / $19.63	Facility	26	$6.00	$8.44	$19.63
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $34.56 / $127.76 / $327.60	Facility	TC	$34.56	$127.76	$327.60
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $43.96 / $127.70	Professional		$15.14	$43.96	$127.70
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $6.01 / $9.22 / $26.60	Professional	26	$6.01	$9.22	$26.60
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $69.58 / $143.86 / $143.86	Professional	50	$69.58	$143.86	$143.86
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $15.39 / $18.36 / $41.44	Professional	52	$15.39	$18.36	$41.44
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $25.10 / $34.63 / $65.88	Professional	TC	$25.10	$34.63	$65.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.15 / $32.36 / $68.26	Professional		$7.15	$32.36	$68.26
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $4.33 / $7.66 / $7.66	Facility	26	$4.33	$7.66	$7.66
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $11.12 / $35.40 / $35.40	Facility	TC	$11.12	$35.40	$35.40
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $24.93 / $39.13 / $66.09	Professional		$24.93	$39.13	$66.09
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.13 / $8.08 / $13.40	Professional	26	$5.13	$8.08	$13.40
Priority Health Facility/Professional Professional Modifier 50 Low / Median / High Price $43.71 / $49.70 / $52.65	Professional	50	$43.71	$49.70	$52.65
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.96 / $30.49 / $54.07	Professional	TC	$17.96	$30.49	$54.07
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $6.61 / $7.50	Facility	26	$6.61	$6.61	$7.50
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $20.37 / $29.71 / $29.71	Facility	TC	$20.37	$29.71	$29.71
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $27.87 / $36.32 / $39.60	Professional		$27.87	$36.32	$39.60
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $6.43 / $6.62 / $7.50	Professional	26	$6.43	$6.62	$7.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $20.37 / $29.71 / $32.71	Professional	TC	$20.37	$29.71	$32.71
United Facility/Professional Professional Modifier Low / Median / High Price $23.89 / $36.88 / $63.67	Professional		$23.89	$36.88	$63.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.30 / $7.94 / $13.37	Professional	26	$6.30	$7.94	$13.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.87 / $29.76 / $51.15	Professional	TC	$20.87	$29.76	$51.15