Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.96 / $12.30 / $22.21	Facility	26	$9.96	$12.30	$22.21
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.88 / $209.93 / $398.34	Facility	TC	$28.88	$209.93	$398.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.19 / $36.15 / $154.00	Professional		$30.19	$36.15	$154.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.64 / $12.95 / $47.20	Professional	26	$9.64	$12.95	$47.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.25 / $24.00 / $88.80	Professional	TC	$19.25	$24.00	$88.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $24.18 / $27.63 / $37.11	Professional		$24.18	$27.63	$37.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $14.70 / $18.25	Professional	26	$8.52	$14.70	$18.25
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $38.58 / $38.58 / $38.58	Professional	TC	$38.58	$38.58	$38.58
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $12.84 / $15.01 / $319.06	Professional	26	$12.84	$15.01	$319.06
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $95.73 / $127.84 / $170.41	Facility	TC	$95.73	$127.84	$170.41
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $35.86 / $52.65 / $60.93	Professional		$35.86	$52.65	$60.93
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $17.93 / $21.96	Professional	26	$11.07	$17.93	$21.96
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $24.79 / $34.47 / $40.36	Professional	TC	$24.79	$34.47	$40.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.57 / $42.26 / $67.12	Professional		$26.57	$42.26	$67.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.95 / $13.99 / $22.01	Professional	26	$7.95	$13.99	$22.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.68 / $27.68 / $46.05	Professional	TC	$18.68	$27.68	$46.05
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $47.86 / $57.60	Professional		$36.54	$47.86	$57.60
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.12 / $14.58 / $22.97	Professional	26	$12.12	$14.58	$22.97
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.71 / $36.90 / $52.51	Professional	TC	$29.71	$36.90	$52.51
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $147.19 / $353.07 / $488.92	Facility	TC	$147.19	$353.07	$488.92
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.39 / $43.22 / $47.09	Professional		$40.39	$43.22	$47.09
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $12.96 / $17.48	Professional	26	$11.75	$12.96	$17.48
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $37.24 / $37.24 / $37.24	Professional	TC	$37.24	$37.24	$37.24
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $11.66 / $15.01 / $191.44	Professional	26	$11.66	$15.01	$191.44
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $9.96 / $13.74 / $32.22	Facility	26	$9.96	$13.74	$32.22
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $26.30 / $156.87 / $407.33	Facility	TC	$26.30	$156.87	$407.33
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $43.98 / $136.80	Professional		$30.40	$43.98	$136.80
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $9.96 / $14.51 / $39.78	Professional	26	$9.96	$14.51	$39.78
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $27.39 / $60.65	Professional	TC	$21.00	$27.39	$60.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $34.50 / $59.42	Professional		$11.75	$34.50	$59.42
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $12.36 / $12.36 / $12.36	Facility	26	$12.36	$12.36	$12.36
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $29.08 / $29.08 / $29.08	Facility	TC	$29.08	$29.08	$29.08
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $26.70 / $42.06 / $67.12	Professional		$26.70	$42.06	$67.12
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $14.07 / $22.01	Professional	26	$8.27	$14.07	$22.01
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.71 / $27.42 / $44.87	Professional	TC	$18.71	$27.42	$44.87
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $10.95 / $10.95 / $12.76	Facility	26	$10.95	$10.95	$12.76
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $22.65 / $24.65 / $24.65	Facility	TC	$22.65	$24.65	$24.65
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $35.60 / $38.50	Professional		$35.09	$35.60	$38.50
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.68 / $10.95 / $12.76	Professional	26	$10.68	$10.95	$12.76
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.65 / $24.65 / $27.14	Professional	TC	$22.65	$24.65	$27.14
United Facility/Professional Professional Modifier Low / Median / High Price $30.30 / $37.21 / $65.56	Professional		$30.30	$37.21	$65.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.52 / $12.78 / $21.63	Professional	26	$10.52	$12.78	$21.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.23 / $25.73 / $43.07	Professional	TC	$20.23	$25.73	$43.07