Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.52 / $41.97 / $95.90	Facility	26	$33.52	$41.97	$95.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.40 / $141.66 / $461.00	Professional		$82.40	$141.66	$461.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.23 / $52.08 / $130.18	Professional	26	$31.23	$52.08	$130.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.93 / $64.31 / $174.33	Professional	TC	$46.93	$64.31	$174.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.23 / $86.76 / $153.65	Professional		$66.23	$86.76	$153.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.81 / $43.36 / $65.42	Professional	26	$26.81	$43.36	$65.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.86 / $82.48 / $93.76	Professional	TC	$39.86	$82.48	$93.76
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $120.95 / $129.41 / $226.69	Professional		$120.95	$129.41	$226.69
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $41.27 / $49.02 / $71.02	Professional	26	$41.27	$49.02	$71.02
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $94.34 / $147.83 / $214.04	Professional		$94.34	$147.83	$214.04
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $37.58 / $59.71 / $88.40	Professional	26	$37.58	$59.71	$88.40
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $56.75 / $89.06 / $125.63	Professional	TC	$56.75	$89.06	$125.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.86 / $40.86 / $40.86	Facility	26	$40.86	$40.86	$40.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.50 / $118.46 / $190.47	Professional		$74.50	$118.46	$190.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.67 / $45.32 / $71.40	Professional	26	$28.67	$45.32	$71.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.64 / $73.28 / $116.36	Professional	TC	$45.64	$73.28	$116.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $106.85 / $126.81 / $272.45	Professional		$106.85	$126.81	$272.45
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.28 / $51.30 / $100.64	Professional	26	$40.28	$51.30	$100.64
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.09 / $86.27 / $171.82	Professional	TC	$67.09	$86.27	$171.82
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $379.77 / $379.77 / $379.77	Facility	26	$379.77	$379.77	$379.77
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.01 / $115.77 / $151.13	Professional		$101.01	$115.77	$151.13
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.92 / $44.89 / $65.33	Professional	26	$38.92	$44.89	$65.33
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.71 / $67.90 / $83.09	Professional	TC	$59.71	$67.90	$83.09
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $104.00 / $131.34 / $212.05	Professional		$104.00	$131.34	$212.05
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $37.43 / $49.02 / $75.73	Professional	26	$37.43	$49.02	$75.73
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $149.63 / $149.63 / $149.63	Professional		$149.63	$149.63	$149.63
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $32.29 / $46.82 / $104.54	Facility	26	$32.29	$46.82	$104.54
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $86.12 / $147.16 / $429.00	Professional		$86.12	$147.16	$429.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $32.29 / $54.14 / $115.58	Professional	26	$32.29	$54.14	$115.58
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $49.72 / $70.76 / $161.41	Professional	TC	$49.72	$70.76	$161.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.70 / $95.00 / $168.46	Professional		$37.70	$95.00	$168.46
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $40.86 / $40.86 / $40.86	Facility	26	$40.86	$40.86	$40.86
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $75.45 / $117.68 / $190.47	Professional		$75.45	$117.68	$190.47
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.35 / $45.32 / $71.40	Professional	26	$29.35	$45.32	$71.40
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.01 / $72.64 / $114.49	Professional	TC	$50.01	$72.64	$114.49
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $35.50 / $35.50 / $57.50	Facility	26	$35.50	$35.50	$57.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $88.65 / $89.87 / $120.00	Professional		$88.65	$89.87	$120.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $34.59 / $35.51 / $57.50	Professional	26	$34.59	$35.51	$57.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $53.21 / $54.37 / $62.50	Professional	TC	$53.21	$54.37	$62.50
United Facility/Professional Professional Modifier Low / Median / High Price $77.72 / $101.18 / $171.66	Professional		$77.72	$101.18	$171.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.06 / $42.34 / $74.20	Professional	26	$30.06	$42.34	$74.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.14 / $65.84 / $106.02	Professional	TC	$47.14	$65.84	$106.02