Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.41 / $13.39 / $30.94	Facility	26	$10.41	$13.39	$30.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.36 / $42.64 / $288.58	Professional		$21.36	$42.64	$288.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.61 / $9.93 / $54.00	Professional	26	$8.61	$9.93	$54.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.33 / $19.76 / $92.72	Professional	TC	$12.33	$19.76	$92.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.89 / $25.74 / $43.10	Professional		$16.89	$25.74	$43.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.26 / $10.11 / $14.44	Professional	26	$7.26	$10.11	$14.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.44 / $24.26 / $24.26	Professional	TC	$14.44	$24.26	$24.26
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $27.72 / $28.29 / $30.64	Professional		$27.72	$28.29	$30.64
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $10.91 / $12.74 / $25.63	Professional	26	$10.91	$12.74	$25.63
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $24.97 / $25.92 / $42.59	Professional		$24.97	$25.92	$42.59
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $9.40 / $9.76 / $18.37	Professional	26	$9.40	$9.76	$18.37
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $15.57 / $16.16 / $25.44	Professional	TC	$15.57	$16.16	$25.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $5.59 / $5.59 / $5.59	Facility	53	$5.59	$5.59	$5.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.39 / $46.41 / $156.33	Professional		$20.39	$46.41	$156.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $12.17 / $18.67	Professional	26	$7.01	$12.17	$18.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.42 / $27.75 / $143.63	Professional	TC	$12.42	$27.75	$143.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $29.99 / $38.75 / $126.72	Professional		$29.99	$38.75	$126.72
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.29 / $12.34 / $19.47	Professional	26	$10.29	$12.34	$19.47
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.68 / $23.16 / $32.93	Professional	TC	$18.68	$23.16	$32.93
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.09 / $12.63 / $13.56	Professional	26	$9.09	$12.63	$13.56
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $27.72 / $28.29 / $31.68	Professional		$27.72	$28.29	$31.68
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $12.67 / $25.63	Professional	26	$9.86	$12.67	$25.63
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $10.41 / $14.04 / $33.34	Facility	26	$10.41	$14.04	$33.34
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $21.36 / $36.00 / $203.94	Professional		$21.36	$36.00	$203.94
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $8.96 / $10.42 / $49.00	Professional	26	$8.96	$10.42	$49.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $12.33 / $20.98 / $76.31	Professional	TC	$12.33	$20.98	$76.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.68 / $22.04 / $113.30	Professional		$9.68	$22.04	$113.30
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $7.02 / $10.80 / $10.80	Facility	26	$7.02	$10.80	$10.80
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $5.59 / $5.59 / $5.59	Facility	53	$5.59	$5.59	$5.59
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $20.46 / $42.22 / $156.11	Professional		$20.46	$42.22	$156.11
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $12.17 / $19.09	Professional	26	$7.01	$12.17	$19.09
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.57 / $26.13 / $143.58	Professional	TC	$12.57	$26.13	$143.58
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $12.00	Facility	26	$9.30	$9.30	$12.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $22.84 / $23.20 / $144.00	Professional		$22.84	$23.20	$144.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.06 / $9.30 / $12.00	Professional	26	$9.06	$9.30	$12.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $13.65 / $13.90 / $132.00	Professional	TC	$13.65	$13.90	$132.00
United Facility/Professional Professional Modifier Low / Median / High Price $20.65 / $30.50 / $124.19	Professional		$20.65	$30.50	$124.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.64 / $10.90 / $18.60	Professional	26	$8.64	$10.90	$18.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.27 / $16.94 / $99.70	Professional	TC	$11.27	$16.94	$99.70