Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $25.12 / $38.90	Facility	26	$12.59	$25.12	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $42.66 / $302.00	Professional		$21.88	$42.66	$302.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.59 / $54.95	Professional	26	$8.91	$12.59	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $25.12 / $190.55	Professional	TC	$12.88	$25.12	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $28.18 / $43.65	Professional		$19.95	$28.18	$43.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.25 / $11.22 / $16.98	Professional	26	$5.25	$11.22	$16.98
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $14.79 / $14.79	Professional	TC	$14.79	$14.79	$14.79
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.70 / $54.95	Professional		$25.12	$25.70	$54.95
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $9.77 / $18.20	Professional	26	$9.33	$9.77	$18.20
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $16.22 / $30.90	Professional	TC	$15.49	$16.22	$30.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.29 / $10.72 / $15.14	Facility	26	$2.29	$10.72	$15.14
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $3.09 / $5.13 / $7.94	Facility	53	$3.09	$5.13	$7.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $44.67 / $154.88	Professional		$20.42	$44.67	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $12.30 / $19.95	Professional	26	$7.08	$12.30	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $28.84 / $138.04	Professional	TC	$12.30	$28.84	$138.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $34.67 / $42.66	Professional		$26.92	$34.67	$42.66
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.30 / $15.14	Professional	26	$9.55	$12.30	$15.14
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $21.88 / $28.18	Professional	TC	$17.38	$21.88	$28.18
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $43.65 / $138.04	Professional		$26.30	$43.65	$138.04
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.30 / $20.89	Professional	26	$9.12	$12.30	$20.89
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $32.36 / $125.89	Professional	TC	$16.22	$32.36	$125.89
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.70 / $48.98	Professional		$25.12	$25.70	$48.98
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $10.00 / $14.45	Professional	26	$8.91	$10.00	$14.45
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $11.75 / $15.14	Professional	26	$10.72	$11.75	$15.14
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $20.42 / $34.67	Facility	26	$12.59	$20.42	$34.67
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $43.65 / $263.03	Professional		$22.91	$43.65	$263.03
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $51.29	Professional	26	$8.91	$14.13	$51.29
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $25.70 / $144.54	Professional	TC	$13.18	$25.70	$144.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $48.98 / $181.97	Professional		$15.85	$48.98	$181.97
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $12.02 / $12.02	Facility	26	$9.33	$12.02	$12.02
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $14.45 / $25.12 / $69.18	Professional		$14.45	$25.12	$69.18
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.55 / $12.02	Professional	26	$9.12	$9.55	$12.02
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $14.13 / $131.83	Professional	TC	$13.80	$14.13	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $30.20 / $128.82	Professional		$20.42	$30.20	$128.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.47 / $16.60	Professional	26	$8.13	$10.47	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $17.38 / $102.33	Professional	TC	$11.22	$17.38	$102.33