Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.72 / $59.41 / $105.25	Facility	26	$47.72	$59.41	$105.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.82 / $149.69 / $613.25	Professional		$48.82	$149.69	$613.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.34 / $59.42 / $220.95	Professional	26	$44.34	$59.42	$220.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.56 / $131.69 / $248.65	Professional	TC	$78.56	$131.69	$248.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.81 / $98.32 / $104.42	Professional		$68.81	$98.32	$104.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $56.15 / $81.50	Professional	26	$36.15	$56.15	$81.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $60.35 / $60.35 / $60.35	Professional	TC	$60.35	$60.35	$60.35
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $54.54 / $64.13 / $1,162.79	Professional	26	$54.54	$64.13	$1,162.79
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $128.05 / $190.61 / $539.79	Professional		$128.05	$190.61	$539.79
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $47.00 / $76.17 / $127.20	Professional	26	$47.00	$76.17	$127.20
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $256.10 / $381.22 / $1,079.61	Professional	50	$256.10	$381.22	$1,079.61
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $81.05 / $121.91 / $412.58	Professional	TC	$81.05	$121.91	$412.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.76 / $244.28 / $421.09	Professional		$123.76	$244.28	$421.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.71 / $59.86 / $94.86	Professional	26	$35.71	$59.86	$94.86
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $231.80 / $264.70 / $264.70	Professional	50	$231.80	$264.70	$264.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.11 / $164.77 / $324.86	Professional	TC	$84.11	$164.77	$324.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $153.59 / $203.25 / $621.14	Professional		$153.59	$203.25	$621.14
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.38 / $61.75 / $97.55	Professional	26	$51.38	$61.75	$97.55
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $96.99 / $120.79 / $172.06	Professional	TC	$96.99	$120.79	$172.06
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.21 / $155.25 / $173.29	Professional		$145.21	$155.25	$173.29
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.51 / $58.85 / $88.14	Professional	26	$52.51	$58.85	$88.14
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $109.21 / $109.21 / $109.21	Professional	50	$109.21	$109.21	$109.21
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.82 / $150.97 / $151.11	Professional	TC	$125.82	$150.97	$151.11
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $49.40 / $59.06 / $114.38	Professional	26	$49.40	$59.06	$114.38
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $45.45 / $65.67 / $155.80	Facility	26	$45.45	$65.67	$155.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $54.62 / $152.87 / $565.63	Professional		$54.62	$152.87	$565.63
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $44.49 / $62.96 / $163.00	Professional	26	$44.49	$62.96	$163.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $80.25 / $117.31 / $298.20	Professional	TC	$80.25	$117.31	$298.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $49.70 / $125.02 / $325.00	Professional		$49.70	$125.02	$325.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $35.84 / $54.02 / $54.02	Facility	26	$35.84	$54.02	$54.02
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $127.81 / $235.00 / $416.36	Professional		$127.81	$235.00	$416.36
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.90 / $59.86 / $96.76	Professional	26	$35.90	$59.86	$96.76
Priority Health Facility/Professional Professional Modifier 50 Low / Median / High Price $231.80 / $264.70 / $264.70	Professional	50	$231.80	$264.70	$264.70
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.11 / $164.77 / $307.86	Professional	TC	$84.11	$164.77	$307.86
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $46.50 / $46.50 / $58.00	Facility	26	$46.50	$46.50	$58.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $127.17 / $129.01 / $248.00	Professional		$127.17	$129.01	$248.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $45.37 / $46.50 / $58.00	Professional	26	$45.37	$46.50	$58.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $80.70 / $82.51 / $190.00	Professional	TC	$80.70	$82.51	$190.00
United Facility/Professional Professional Modifier Low / Median / High Price $134.78 / $197.61 / $311.92	Professional		$134.78	$197.61	$311.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.30 / $56.30 / $94.25	Professional	26	$45.30	$56.30	$94.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.48 / $129.26 / $234.32	Professional	TC	$89.48	$129.26	$234.32