Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.74 / $29.70 / $78.65	Facility	26	$24.74	$29.70	$78.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.18 / $94.92 / $333.93	Professional		$48.18	$94.92	$333.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.02 / $30.96 / $81.39	Professional	26	$24.02	$30.96	$81.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.82 / $42.94 / $124.42	Professional	TC	$24.82	$42.94	$124.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.01 / $45.72 / $56.77	Professional		$40.01	$45.72	$56.77
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.76 / $25.29 / $44.78	Professional	26	$20.76	$25.29	$44.78
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $49.45 / $49.45 / $55.50	Professional	TC	$49.45	$49.45	$55.50
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $73.05 / $73.56 / $128.97	Professional		$73.05	$73.56	$128.97
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $59.30 / $61.53 / $99.37	Professional		$59.30	$61.53	$99.37
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $27.52 / $44.57 / $67.68	Professional	26	$27.52	$44.57	$67.68
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $31.78 / $45.13 / $90.40	Professional	TC	$31.78	$45.13	$90.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.69 / $93.55 / $161.61	Professional		$51.69	$93.55	$161.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.06 / $35.25 / $55.89	Professional	26	$22.06	$35.25	$55.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.10 / $50.81 / $108.64	Professional	TC	$27.10	$50.81	$108.64
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $70.75 / $93.47 / $143.58	Professional		$70.75	$93.47	$143.58
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.21 / $39.84 / $62.38	Professional	26	$31.21	$39.84	$62.38
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $39.76 / $51.12 / $81.22	Professional	TC	$39.76	$51.12	$81.22
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.58 / $72.68 / $84.08	Professional		$66.58	$72.68	$84.08
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.38 / $34.27 / $47.40	Professional	26	$30.38	$34.27	$47.40
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.60 / $42.24 / $44.77	Professional	TC	$38.60	$42.24	$44.77
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $61.61 / $73.56 / $128.97	Professional		$61.61	$73.56	$128.97
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $352.33 / $352.33 / $352.33	Professional	26	$352.33	$352.33	$352.33
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $24.74 / $35.38 / $80.19	Facility	26	$24.74	$35.38	$80.19
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $51.04 / $99.15 / $280.79	Professional		$51.04	$99.15	$280.79
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $24.74 / $36.34 / $79.65	Professional	26	$24.74	$36.34	$79.65
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $45.34 / $112.54	Professional	TC	$26.30	$45.34	$112.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.96 / $83.91 / $153.80	Professional		$30.96	$83.91	$153.80
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $31.27 / $31.27 / $31.27	Facility	26	$31.27	$31.27	$31.27
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $52.50 / $90.62 / $159.79	Professional		$52.50	$90.62	$159.79
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.44 / $35.25 / $55.89	Professional	26	$22.44	$35.25	$55.89
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.84 / $49.87 / $106.00	Professional	TC	$27.84	$49.87	$106.00
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $27.21 / $27.21 / $42.00	Facility	26	$27.21	$27.21	$42.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $56.28 / $57.23 / $110.19	Professional		$56.28	$57.23	$110.19
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.45 / $27.28 / $42.00	Professional	26	$26.45	$27.28	$42.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $29.41 / $30.03 / $68.19	Professional	TC	$29.41	$30.03	$68.19
United Facility/Professional Professional Modifier Low / Median / High Price $52.89 / $71.50 / $129.58	Professional		$52.89	$71.50	$129.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.81 / $31.59 / $53.64	Professional	26	$23.81	$31.59	$53.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.15 / $37.83 / $90.22	Professional	TC	$26.15	$37.83	$90.22