Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.52 / $11.41 / $19.89	Facility	26	$8.52	$11.41	$19.89
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.91 / $154.77 / $256.19	Facility	TC	$23.91	$154.77	$256.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.14 / $32.04 / $109.23	Professional		$21.14	$32.04	$109.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.81 / $9.44 / $37.00	Professional	26	$7.81	$9.44	$37.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $21.68 / $46.01	Professional	TC	$18.32	$21.68	$46.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.89 / $21.72 / $24.88	Professional		$19.89	$21.72	$24.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.98 / $12.35 / $14.97	Professional	26	$6.98	$12.35	$14.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $18.68 / $18.68 / $18.68	Professional	TC	$18.68	$18.68	$18.68
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $86.71 / $115.79 / $154.35	Facility	TC	$86.71	$115.79	$154.35
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $32.22 / $46.81 / $54.02	Professional		$32.22	$46.81	$54.02
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $14.65 / $17.64	Professional	26	$9.02	$14.65	$17.64
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $23.20 / $31.83 / $37.26	Professional	TC	$23.20	$31.83	$37.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.15 / $27.15 / $27.15	Facility	TC	$27.15	$27.15	$27.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.96 / $37.27 / $59.94	Professional		$23.96	$37.27	$59.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.64 / $11.42 / $18.05	Professional	26	$6.64	$11.42	$18.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.26 / $25.17 / $42.23	Professional	TC	$17.26	$25.17	$42.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $32.38 / $43.19 / $52.12	Professional		$32.38	$43.19	$52.12
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $11.95 / $18.72	Professional	26	$9.94	$11.95	$18.72
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.80 / $34.54 / $49.15	Professional	TC	$27.80	$34.54	$49.15
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $92.92 / $157.66 / $311.23	Facility	TC	$92.92	$157.66	$311.23
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.35 / $39.99 / $42.43	Professional		$36.35	$39.99	$42.43
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.46 / $10.91 / $15.46	Professional	26	$9.46	$10.91	$15.46
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.38 / $34.38 / $34.61	Professional	TC	$34.38	$34.38	$34.61
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $34.40 / $34.40 / $34.40	Professional		$34.40	$34.40	$34.40
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $11.78 / $28.48	Facility	26	$8.13	$11.78	$28.48
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $23.91 / $109.56 / $263.08	Facility	TC	$23.91	$109.56	$263.08
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $21.45 / $36.58 / $96.78	Professional		$21.45	$36.58	$96.78
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.05 / $27.68	Professional	26	$8.13	$10.05	$27.68
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $19.07 / $24.27 / $53.08	Professional	TC	$19.07	$24.27	$53.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.31 / $32.79 / $62.96	Professional		$10.31	$32.79	$62.96
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $10.36 / $10.36	Facility	26	$10.36	$10.36	$10.36
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $27.15 / $27.15 / $27.15	Facility	TC	$27.15	$27.15	$27.15
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $23.85 / $36.88 / $59.94	Professional		$23.85	$36.88	$59.94
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $11.42 / $18.05	Professional	26	$6.80	$11.42	$18.05
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.26 / $25.17 / $41.41	Professional	TC	$17.26	$25.17	$41.41
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.94 / $8.94 / $10.42	Facility	26	$8.94	$8.94	$10.42
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $20.89 / $22.75 / $22.75	Facility	TC	$20.89	$22.75	$22.75
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $31.24 / $31.69 / $34.35	Professional		$31.24	$31.69	$34.35
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $8.94 / $10.42	Professional	26	$8.71	$8.94	$10.42
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $22.75 / $25.06	Professional	TC	$20.89	$22.75	$25.06
United Facility/Professional Professional Modifier Low / Median / High Price $27.22 / $33.95 / $58.76	Professional		$27.22	$33.95	$58.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.60 / $10.63 / $17.88	Professional	26	$8.60	$10.63	$17.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.87 / $24.08 / $39.86	Professional	TC	$18.87	$24.08	$39.86