Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.79 / $28.31 / $71.40	Facility	26	$23.79	$28.31	$71.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.57 / $113.74 / $397.50	Professional		$84.57	$113.74	$397.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.01 / $26.70 / $80.59	Professional	26	$22.01	$26.70	$80.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.92 / $90.71 / $167.75	Professional	TC	$59.92	$90.71	$167.75
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.48 / $33.22 / $41.53	Professional	26	$19.48	$33.22	$41.53
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $29.20 / $34.65 / $224.70	Professional	26	$29.20	$34.65	$224.70
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $117.33 / $121.76 / $153.07	Professional		$117.33	$121.76	$153.07
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $25.16 / $41.28 / $61.08	Professional	26	$25.16	$41.28	$61.08
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $95.66 / $176.25	Professional	TC	$83.18	$95.66	$176.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.92 / $28.92 / $28.92	Facility	26	$28.92	$28.92	$28.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.61 / $123.60 / $227.89	Professional		$82.61	$123.60	$227.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.62 / $31.42 / $50.81	Professional	26	$19.62	$31.42	$50.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $55.34 / $89.26 / $183.52	Professional	TC	$55.34	$89.26	$183.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $103.97 / $157.72 / $209.61	Professional		$103.97	$157.72	$209.61
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.58 / $33.06 / $52.12	Professional	26	$27.58	$33.06	$52.12
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $110.29 / $137.36 / $195.69	Professional	TC	$110.29	$137.36	$195.69
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.81 / $147.47 / $151.07	Professional		$142.81	$147.47	$151.07
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $30.30 / $42.97	Professional	26	$27.54	$30.30	$42.97
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $26.45 / $32.88 / $60.75	Professional	26	$26.45	$32.88	$60.75
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $31.81 / $74.39	Facility	26	$22.91	$31.81	$74.39
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $95.23 / $132.18 / $272.29	Professional		$95.23	$132.18	$272.29
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $33.00 / $74.97	Professional	26	$22.91	$33.00	$74.97
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $67.86 / $107.12 / $188.65	Professional	TC	$67.86	$107.12	$188.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $96.20 / $96.20 / $328.00	Professional		$96.20	$96.20	$328.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $17.17 / $28.92 / $28.92	Facility	26	$17.17	$28.92	$28.92
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $82.61 / $124.25 / $221.92	Professional		$82.61	$124.25	$221.92
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.63 / $31.15 / $51.10	Professional	26	$19.63	$31.15	$51.10
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.19 / $91.51 / $174.29	Professional	TC	$56.19	$91.51	$174.29
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $25.20 / $25.20 / $32.00	Facility	26	$25.20	$25.20	$32.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $83.50 / $121.93 / $132.65	Professional		$83.50	$121.93	$132.65
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $24.48 / $25.27 / $32.00	Professional	26	$24.48	$25.27	$32.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $51.50 / $96.74 / $106.49	Professional	TC	$51.50	$96.74	$106.49
United Facility/Professional Professional Modifier Low / Median / High Price $75.39 / $131.37 / $236.37	Professional		$75.39	$131.37	$236.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.88 / $29.47 / $49.11	Professional	26	$23.88	$29.47	$49.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.02 / $103.60 / $186.76	Professional	TC	$61.02	$103.60	$186.76