Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.32 / $30.56 / $69.95	Facility	26	$23.32	$30.56	$69.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.03 / $60.35 / $242.00	Professional		$39.03	$60.35	$242.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.23 / $31.40 / $113.36	Professional	26	$20.23	$31.40	$113.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.44 / $23.10 / $43.86	Professional	TC	$17.44	$23.10	$43.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.28 / $40.97 / $66.34	Professional		$32.28	$40.97	$66.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.66 / $36.09 / $43.23	Professional	26	$21.66	$36.09	$43.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.26 / $30.26 / $30.26	Professional	TC	$30.26	$30.26	$30.26
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $58.02 / $63.54 / $117.52	Professional		$58.02	$63.54	$117.52
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $29.73 / $39.22 / $46.53	Professional	26	$29.73	$39.22	$46.53
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $43.21 / $71.22 / $150.26	Professional		$43.21	$71.22	$150.26
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $23.50 / $38.10 / $60.74	Professional	26	$23.50	$38.10	$60.74
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $19.71 / $32.79 / $104.06	Professional	TC	$19.71	$32.79	$104.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.99 / $26.99 / $26.99	Facility	26	$26.99	$26.99	$26.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.51 / $64.14 / $122.93	Professional		$39.51	$64.14	$122.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.02 / $30.81 / $47.32	Professional	26	$19.02	$30.81	$47.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.59 / $32.57 / $73.61	Professional	TC	$18.59	$32.57	$73.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $50.89 / $60.25 / $129.22	Professional		$50.89	$60.25	$129.22
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.53 / $33.65 / $65.81	Professional	26	$26.53	$33.65	$65.81
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.72 / $31.78 / $63.42	Professional	TC	$24.72	$31.78	$63.42
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $141.30 / $141.30 / $141.30	Facility	26	$141.30	$141.30	$141.30
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.42 / $58.97 / $84.23	Professional		$50.42	$58.97	$84.23
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $28.66 / $48.85	Professional	26	$25.70	$28.66	$48.85
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.17 / $29.17 / $30.92	Professional	TC	$29.17	$29.17	$30.92
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $58.02 / $61.54 / $112.33	Professional		$58.02	$61.54	$112.33
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $29.73 / $39.22 / $50.03	Professional	26	$29.73	$39.22	$50.03
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $23.32 / $35.11 / $73.72	Facility	26	$23.32	$35.11	$73.72
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $39.94 / $67.44 / $232.00	Professional		$39.94	$67.44	$232.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $21.37 / $35.11 / $89.38	Professional	26	$21.37	$35.11	$89.38
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $25.42 / $57.84	Professional	TC	$18.48	$25.42	$57.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.58 / $44.06 / $111.30	Professional		$21.58	$44.06	$111.30
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $26.99 / $26.99 / $26.99	Facility	26	$26.99	$26.99	$26.99
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $40.11 / $61.88 / $114.45	Professional		$40.11	$61.88	$114.45
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.39 / $30.76 / $47.32	Professional	26	$19.39	$30.76	$47.32
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.59 / $29.67 / $70.28	Professional	TC	$18.59	$29.67	$70.28
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $23.26 / $23.26 / $27.00	Facility	26	$23.26	$23.26	$27.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $42.83 / $43.48 / $88.00	Professional		$42.83	$43.48	$88.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.76 / $23.26 / $27.00	Professional	26	$22.76	$23.26	$27.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.82 / $20.23 / $61.00	Professional	TC	$19.82	$20.23	$61.00
United Facility/Professional Professional Modifier Low / Median / High Price $41.01 / $55.14 / $93.83	Professional		$41.01	$55.14	$93.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.13 / $27.68 / $46.42	Professional	26	$20.13	$27.68	$46.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.36 / $25.02 / $50.13	Professional	TC	$18.36	$25.02	$50.13