Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.17 / $45.82 / $104.28	Facility	26	$36.17	$45.82	$104.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.67 / $115.26 / $433.46	Professional		$73.67	$115.26	$433.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.33 / $48.56 / $158.22	Professional	26	$31.33	$48.56	$158.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.20 / $53.34 / $85.96	Professional	TC	$38.20	$53.34	$85.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.49 / $92.36 / $126.11	Professional		$62.49	$92.36	$126.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $43.10 / $66.69	Professional	26	$27.50	$43.10	$66.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $72.73 / $72.73 / $72.73	Professional	TC	$72.73	$72.73	$72.73
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $802.05 / $802.05 / $802.05	Professional		$802.05	$802.05	$802.05
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $46.10 / $60.81 / $68.75	Professional	26	$46.10	$60.81	$68.75
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $83.61 / $133.33 / $172.55	Professional		$83.61	$133.33	$172.55
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $36.25 / $58.77 / $91.40	Professional	26	$36.25	$58.77	$91.40
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $47.36 / $73.09 / $102.96	Professional	TC	$47.36	$73.09	$102.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $41.65 / $41.65	Facility	26	$41.65	$41.65	$41.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.00 / $114.03 / $173.33	Professional		$69.00	$114.03	$173.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.45 / $46.75 / $73.40	Professional	26	$29.45	$46.75	$73.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.18 / $67.34 / $108.73	Professional	TC	$41.18	$67.34	$108.73
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $99.73 / $118.20 / $253.98	Professional		$99.73	$118.20	$253.98
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.98 / $52.02 / $101.84	Professional	26	$40.98	$52.02	$101.84
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $59.34 / $76.29 / $152.16	Professional	TC	$59.34	$76.29	$152.16
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.37 / $106.43 / $128.97	Professional		$94.37	$106.43	$128.97
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.95 / $42.64 / $59.39	Professional	26	$38.95	$42.64	$59.39
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.71 / $63.81 / $67.63	Professional	TC	$54.71	$63.81	$67.63
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $802.05 / $802.05 / $802.05	Professional		$802.05	$802.05	$802.05
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $46.10 / $58.95 / $77.17	Professional	26	$46.10	$58.95	$77.17
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $33.20 / $48.14 / $114.33	Facility	26	$33.20	$48.14	$114.33
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $76.48 / $126.77 / $269.32	Professional		$76.48	$126.77	$269.32
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $33.20 / $51.61 / $119.80	Professional	26	$33.20	$51.61	$119.80
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $40.46 / $60.53 / $111.81	Professional	TC	$40.46	$60.53	$111.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.49 / $89.36 / $160.69	Professional		$38.49	$89.36	$160.69
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $41.65 / $41.65 / $41.65	Facility	26	$41.65	$41.65	$41.65
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $70.48 / $111.58 / $173.33	Professional		$70.48	$111.58	$173.33
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.92 / $46.75 / $73.40	Professional	26	$29.92	$46.75	$73.40
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.71 / $65.55 / $103.81	Professional	TC	$42.71	$65.55	$103.81
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $35.88 / $35.88 / $39.36	Facility	26	$35.88	$35.88	$39.36
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $80.33 / $81.40 / $94.67	Professional		$80.33	$81.40	$94.67
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $35.07 / $35.88 / $39.36	Professional	26	$35.07	$35.88	$39.36
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $44.55 / $45.52 / $55.30	Professional	TC	$44.55	$45.52	$55.30
United Facility/Professional Professional Modifier Low / Median / High Price $71.38 / $97.26 / $158.49	Professional		$71.38	$97.26	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $41.91 / $72.34	Professional	26	$30.90	$41.91	$72.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.29 / $55.75 / $91.74	Professional	TC	$41.29	$55.75	$91.74