Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $14.79 / $26.30	Facility	26	$7.08	$14.79	$26.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $39.81 / $131.83	Professional		$17.38	$39.81	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $14.13 / $40.74	Professional	26	$6.92	$14.13	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $125.89 / $263.03	Professional	50	$38.90	$125.89	$263.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.38 / $102.33 / $107.15	Professional	52	$21.38	$102.33	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $25.70 / $85.11	Professional	TC	$15.85	$25.70	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $22.91 / $36.31	Professional		$18.20	$22.91	$36.31
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $8.91 / $12.88	Professional	26	$5.50	$8.91	$12.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $19.05 / $26.92	Professional	TC	$16.60	$19.05	$26.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $32.36 / $57.54	Professional		$27.54	$32.36	$57.54
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.00 / $18.62	Professional	26	$7.76	$10.00	$18.62
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $64.57 / $114.82	Professional	50	$54.95	$64.57	$114.82
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $22.39 / $38.90	Professional	TC	$19.50	$22.39	$38.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.59	Facility	26	$1.86	$8.71	$12.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $33.11 / $58.88	Professional		$21.88	$33.11	$58.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.55 / $15.49	Professional	26	$6.03	$9.55	$15.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $23.99 / $41.69	Professional	TC	$15.49	$23.99	$41.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.90 / $48.98	Professional		$30.20	$38.90	$48.98
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.23 / $12.59	Professional	26	$7.76	$10.23	$12.59
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $28.18 / $36.31	Professional	TC	$22.39	$28.18	$36.31
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $31.62 / $58.88	Professional		$19.95	$31.62	$58.88
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.12 / $16.60	Professional	26	$6.46	$9.12	$16.60
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $22.39 / $42.66	Professional	TC	$13.49	$22.39	$42.66
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $34.67 / $39.81	Professional		$30.90	$34.67	$39.81
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.33 / $12.88	Professional	26	$7.76	$9.33	$12.88
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $52.48 / $79.43	Professional	50	$52.48	$52.48	$79.43
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $25.12 / $25.70	Professional	TC	$25.12	$25.12	$25.70
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $13.80 / $26.30	Facility	26	$7.24	$13.80	$26.30
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $37.15 / $85.11	Professional		$21.38	$37.15	$85.11
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.96 / $25.70	Professional	26	$6.61	$10.96	$25.70
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $38.90 / $125.89 / $263.03	Professional	50	$38.90	$125.89	$263.03
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $26.30 / $27.54 / $104.71	Professional	52	$26.30	$27.54	$104.71
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $26.30 / $52.48	Professional	TC	$16.98	$26.30	$52.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $42.66 / $60.26	Professional		$33.88	$42.66	$60.26
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $7.59 / $8.51	Facility	26	$7.59	$7.59	$8.51
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $10.23 / $18.62 / $27.54	Professional		$10.23	$18.62	$27.54
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $7.59 / $8.51	Professional	26	$7.41	$7.59	$8.51
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $19.95 / $21.88	Professional	TC	$19.05	$19.95	$21.88
United Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $28.18 / $48.98	Professional		$22.39	$28.18	$48.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.32 / $14.45	Professional	26	$6.17	$8.32	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $20.42 / $34.67	Professional	TC	$15.49	$20.42	$34.67