Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.31 / $18.07 / $28.88	Facility	26	$13.31	$18.07	$28.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $49.45 / $264.11 / $489.79	Facility	TC	$49.45	$264.11	$489.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.16 / $56.18 / $129.03	Professional		$44.16	$56.18	$129.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.09 / $15.04 / $40.98	Professional	26	$12.09	$15.04	$40.98
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $29.84 / $29.84 / $29.84	Professional	50	$29.84	$29.84	$29.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $36.45 / $82.09	Professional	TC	$30.85	$36.45	$82.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.79 / $40.13 / $98.52	Professional		$33.79	$40.13	$98.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $14.61 / $22.90	Professional	26	$10.80	$14.61	$22.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.34 / $29.34 / $29.34	Professional	TC	$29.34	$29.34	$29.34
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $145.47 / $194.27 / $258.97	Facility	TC	$145.47	$194.27	$258.97
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $52.22 / $75.90 / $88.93	Professional		$52.22	$75.90	$88.93
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $14.08 / $22.82 / $28.15	Professional	26	$14.08	$22.82	$28.15
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $38.14 / $51.95 / $61.60	Professional	TC	$38.14	$51.95	$61.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.14 / $16.14 / $16.14	Facility	26	$16.14	$16.14	$16.14
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $44.74 / $44.74 / $44.74	Facility	TC	$44.74	$44.74	$44.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.40 / $60.84 / $97.60	Professional		$39.40	$60.84	$97.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.44 / $17.93 / $28.00	Professional	26	$10.44	$17.93	$28.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.00 / $41.81 / $71.00	Professional	TC	$29.00	$41.81	$71.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $53.48 / $69.90 / $84.06	Professional		$53.48	$69.90	$84.06
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.43 / $18.57 / $29.26	Professional	26	$15.43	$18.57	$29.26
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.67 / $56.81 / $80.89	Professional	TC	$45.67	$56.81	$80.89
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $135.65 / $361.46 / $641.83	Facility	TC	$135.65	$361.46	$641.83
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.49 / $61.87 / $65.45	Professional		$59.49	$61.87	$65.45
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.42 / $16.97 / $23.30	Professional	26	$15.42	$16.97	$23.30
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $59.50 / $59.50 / $63.68	Professional	50	$59.50	$59.50	$63.68
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.47 / $48.47 / $68.73	Professional	TC	$48.47	$48.47	$68.73
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.67 / $18.38 / $43.61	Facility	26	$12.67	$18.38	$43.61
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $40.28 / $221.24 / $510.20	Facility	TC	$40.28	$221.24	$510.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $44.27 / $62.96 / $129.03	Professional		$44.27	$62.96	$129.03
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $12.67 / $17.39 / $40.98	Professional	26	$12.67	$17.39	$40.98
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $29.84 / $29.84 / $29.84	Professional	50	$29.84	$29.84	$29.84
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $32.19 / $41.84 / $86.19	Professional	TC	$32.19	$41.84	$86.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.07 / $54.10 / $101.54	Professional		$16.07	$54.10	$101.54
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $16.14 / $16.14 / $16.14	Facility	26	$16.14	$16.14	$16.14
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $44.74 / $44.74 / $44.74	Facility	TC	$44.74	$44.74	$44.74
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $38.83 / $60.66 / $97.40	Professional		$38.83	$60.66	$97.40
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.62 / $18.05 / $28.00	Professional	26	$10.62	$18.05	$28.00
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.78 / $41.81 / $68.45	Professional	TC	$28.78	$41.81	$68.45
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $13.93 / $13.93 / $16.60	Facility	26	$13.93	$13.93	$16.60
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $34.44 / $37.61 / $37.61	Facility	TC	$34.44	$37.61	$37.61
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $50.72 / $51.54 / $55.87	Professional		$50.72	$51.54	$55.87
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.61 / $13.93 / $16.60	Professional	26	$13.61	$13.93	$16.60
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.44 / $37.61 / $41.41	Professional	TC	$34.44	$37.61	$41.41
United Facility/Professional Professional Modifier Low / Median / High Price $42.93 / $54.19 / $97.18	Professional		$42.93	$54.19	$97.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.39 / $16.68 / $29.61	Professional	26	$13.39	$16.68	$29.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.66 / $40.46 / $66.05	Professional	TC	$31.66	$40.46	$66.05