Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.00 / $7.44 / $16.10	Facility	26	$6.00	$7.44	$16.10
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.17 / $86.92 / $310.43	Facility	TC	$26.17	$86.92	$310.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.96 / $33.44 / $132.00	Professional		$13.96	$33.44	$132.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $8.02 / $25.18	Professional	26	$5.53	$8.02	$25.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.55 / $25.02 / $97.00	Professional	TC	$18.55	$25.02	$97.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.45 / $22.80 / $52.78	Professional		$21.45	$22.80	$52.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.96 / $6.06 / $9.97	Professional	26	$4.96	$6.06	$9.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.23 / $33.64 / $37.76	Professional	TC	$15.23	$33.64	$37.76
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $87.41 / $116.73 / $155.60	Facility	TC	$87.41	$116.73	$155.60
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $27.97 / $42.59 / $49.70	Professional		$27.97	$42.59	$49.70
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $6.36 / $10.30 / $15.50	Professional	26	$6.36	$10.30	$15.50
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $21.61 / $32.25 / $38.39	Professional	TC	$21.61	$32.25	$38.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.31 / $7.31 / $7.31	Facility	26	$7.31	$7.31	$7.31
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $25.73 / $25.73 / $25.73	Facility	TC	$25.73	$25.73	$25.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.94 / $33.52 / $53.37	Professional		$21.94	$33.52	$53.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.91 / $7.89 / $12.49	Professional	26	$4.91	$7.89	$12.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.54 / $25.93 / $41.65	Professional	TC	$16.54	$25.93	$41.65
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $29.67 / $37.65 / $45.69	Professional		$29.67	$37.65	$45.69
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $8.38 / $13.16	Professional	26	$7.01	$8.38	$13.16
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.91 / $32.15 / $45.76	Professional	TC	$25.91	$32.15	$45.76
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $119.37 / $272.58 / $394.08	Facility	TC	$119.37	$272.58	$394.08
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.73 / $34.60 / $41.43	Professional		$24.73	$34.60	$41.43
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.98 / $7.79 / $10.58	Professional	26	$6.98	$7.79	$10.58
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.48 / $27.88 / $32.95	Professional	TC	$27.48	$27.88	$32.95
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $5.72 / $8.18 / $18.62	Facility	26	$5.72	$8.18	$18.62
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $25.54 / $86.92 / $345.10	Facility	TC	$25.54	$86.92	$345.10
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $15.60 / $36.94 / $121.00	Professional		$15.60	$36.94	$121.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $5.71 / $8.75 / $19.72	Professional	26	$5.71	$8.75	$19.72
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $27.32 / $66.19	Professional	TC	$19.64	$27.32	$66.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.41 / $28.90 / $62.50	Professional		$10.41	$28.90	$62.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $4.33 / $7.31 / $7.31	Facility	26	$4.33	$7.31	$7.31
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $11.12 / $25.73 / $25.73	Facility	TC	$11.12	$25.73	$25.73
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $21.94 / $32.97 / $52.26	Professional		$21.94	$32.97	$52.26
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $4.95 / $7.84 / $12.71	Professional	26	$4.95	$7.84	$12.71
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.21 / $25.93 / $41.48	Professional	TC	$17.21	$25.93	$41.48
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $6.29 / $6.29 / $7.50	Facility	26	$6.29	$6.29	$7.50
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $18.97 / $21.81 / $21.81	Facility	TC	$18.97	$21.81	$21.81
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $26.47 / $28.10 / $30.55	Professional		$26.47	$28.10	$30.55
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $6.12 / $6.31 / $7.50	Professional	26	$6.12	$6.31	$7.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $18.97 / $21.81 / $24.01	Professional	TC	$18.97	$21.81	$24.01
United Facility/Professional Professional Modifier Low / Median / High Price $22.69 / $30.25 / $52.46	Professional		$22.69	$30.25	$52.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $7.55 / $12.60	Professional	26	$6.03	$7.55	$12.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.27 / $23.34 / $38.59	Professional	TC	$18.27	$23.34	$38.59