Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.05 / $18.16 / $39.44	Facility	26	$12.05	$18.16	$39.44
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.07 / $146.08 / $364.44	Facility	TC	$31.07	$146.08	$364.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.18 / $40.27 / $155.62	Professional		$35.18	$40.27	$155.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.84 / $12.66 / $30.80	Professional	26	$10.84	$12.66	$30.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $27.64 / $56.30	Professional	TC	$23.17	$27.64	$56.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.83 / $31.83 / $40.51	Professional		$31.83	$31.83	$40.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.67 / $11.95 / $18.46	Professional	26	$9.67	$11.95	$18.46
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.50 / $44.50 / $44.50	Professional	TC	$44.50	$44.50	$44.50
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $111.40 / $148.76 / $198.30	Facility	TC	$111.40	$148.76	$198.30
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $41.36 / $61.00 / $71.37	Professional		$41.36	$61.00	$71.37
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $12.75 / $20.67 / $26.00	Professional	26	$12.75	$20.67	$26.00
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $28.61 / $39.25 / $47.11	Professional	TC	$28.61	$39.25	$47.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $33.92 / $33.92 / $33.92	Facility	TC	$33.92	$33.92	$33.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.17 / $49.01 / $78.05	Professional		$31.17	$49.01	$78.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.47 / $16.39 / $25.34	Professional	26	$9.47	$16.39	$25.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.76 / $31.92 / $53.57	Professional	TC	$21.76	$31.92	$53.57
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $42.75 / $55.15 / $66.31	Professional		$42.75	$55.15	$66.31
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.94 / $16.78 / $26.49	Professional	26	$13.94	$16.78	$26.49
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.26 / $42.59 / $60.63	Professional	TC	$34.26	$42.59	$60.63
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $191.68 / $331.19 / $605.54	Facility	TC	$191.68	$331.19	$605.54
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.02 / $47.37 / $54.31	Professional		$47.02	$47.37	$54.31
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $14.81 / $16.04	Professional	26	$13.19	$14.81	$16.04
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.45 / $43.45 / $43.45	Professional	TC	$43.45	$43.45	$43.45
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.05 / $18.16 / $40.81	Facility	26	$12.05	$18.16	$40.81
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $31.07 / $101.21 / $398.11	Facility	TC	$31.07	$101.21	$398.11
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $35.65 / $44.21 / $128.47	Professional		$35.65	$44.21	$128.47
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $11.35 / $14.16 / $35.22	Professional	26	$11.35	$14.16	$35.22
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $24.82 / $31.07 / $68.14	Professional	TC	$24.82	$31.07	$68.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.33 / $40.14 / $69.31	Professional		$14.33	$40.14	$69.31
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $14.65 / $14.65 / $14.65	Facility	26	$14.65	$14.65	$14.65
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $33.92 / $33.92 / $33.92	Facility	TC	$33.92	$33.92	$33.92
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $31.21 / $48.82 / $77.97	Professional		$31.21	$48.82	$77.97
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.63 / $16.44 / $25.34	Professional	26	$9.63	$16.44	$25.34
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.76 / $31.88 / $52.35	Professional	TC	$21.76	$31.88	$52.35
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $12.62 / $12.62 / $15.11	Facility	26	$12.62	$12.62	$15.11
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $26.36 / $28.76 / $28.76	Facility	TC	$26.36	$28.76	$28.76
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $40.78 / $41.38 / $44.74	Professional		$40.78	$41.38	$44.74
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.32 / $12.62 / $15.11	Professional	26	$12.32	$12.62	$15.11
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.36 / $28.76 / $31.67	Professional	TC	$26.36	$28.76	$31.67
United Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $45.12 / $75.28	Professional		$35.72	$45.12	$75.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.12 / $15.04 / $24.96	Professional	26	$12.12	$15.04	$24.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.06 / $29.69 / $52.31	Professional	TC	$24.06	$29.69	$52.31