Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.86 / $24.92 / $44.84	Facility	26	$20.86	$24.92	$44.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.90 / $82.34 / $311.95	Professional		$40.90	$82.34	$311.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.64 / $30.74 / $79.50	Professional	26	$17.64	$30.74	$79.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.91 / $36.54 / $100.45	Professional	TC	$19.91	$36.54	$100.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.37 / $37.67 / $83.72	Professional		$23.37	$37.67	$83.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.79 / $22.40 / $36.09	Professional	26	$17.79	$22.40	$36.09
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $20.47 / $21.82 / $39.57	Professional	TC	$20.47	$21.82	$39.57
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $59.35 / $64.88 / $115.20	Professional		$59.35	$64.88	$115.20
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $26.26 / $34.61 / $56.78	Professional	26	$26.26	$34.61	$56.78
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $48.93 / $75.45 / $140.41	Professional		$48.93	$75.45	$140.41
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $23.50 / $38.08 / $46.54	Professional	26	$23.50	$38.08	$46.54
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $25.43 / $36.00 / $106.88	Professional	TC	$25.43	$36.00	$106.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.65 / $26.65 / $26.65	Facility	26	$26.65	$26.65	$26.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.39 / $77.41 / $144.59	Professional		$42.39	$77.41	$144.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.73 / $26.07 / $44.40	Professional	26	$17.73	$26.07	$44.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.68 / $45.79 / $112.04	Professional	TC	$21.68	$45.79	$112.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $58.19 / $76.81 / $118.36	Professional		$58.19	$76.81	$118.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.60 / $33.86 / $52.94	Professional	26	$26.60	$33.86	$52.94
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.85 / $40.95 / $65.06	Professional	TC	$31.85	$40.95	$65.06
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.25 / $62.68 / $97.85	Professional		$56.25	$62.68	$97.85
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.88 / $28.80 / $43.38	Professional	26	$25.88	$28.80	$43.38
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.63 / $43.01 / $56.38	Professional	TC	$29.63	$43.01	$56.38
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $56.78 / $64.88 / $115.20	Professional		$56.78	$64.88	$115.20
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $23.45 / $29.72 / $53.62	Professional	26	$23.45	$29.72	$53.62
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $72.28 / $72.28 / $72.28	Professional		$72.28	$72.28	$72.28
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $20.86 / $30.24 / $67.27	Facility	26	$20.86	$30.24	$67.27
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $44.00 / $82.34 / $271.70	Professional		$44.00	$82.34	$271.70
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $19.45 / $31.65 / $69.37	Professional	26	$19.45	$31.65	$69.37
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $21.10 / $36.64 / $98.62	Professional	TC	$21.10	$36.64	$98.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.77 / $51.27 / $101.48	Professional		$24.77	$51.27	$101.48
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $26.65 / $26.65 / $26.65	Facility	26	$26.65	$26.65	$26.65
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $43.97 / $76.61 / $144.59	Professional		$43.97	$76.61	$144.59
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.16 / $26.20 / $43.50	Professional	26	$18.16	$26.20	$43.50
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.73 / $43.57 / $112.04	Professional	TC	$21.73	$43.57	$112.04
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $23.25 / $23.25 / $40.50	Facility	26	$23.25	$23.25	$40.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $46.54 / $47.27 / $62.24	Professional		$46.54	$47.27	$62.24
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.69 / $23.25 / $40.50	Professional	26	$22.69	$23.25	$40.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $23.54 / $24.02 / $52.00	Professional	TC	$23.54	$24.02	$52.00
United Facility/Professional Professional Modifier Low / Median / High Price $43.69 / $62.70 / $112.67	Professional		$43.69	$62.70	$112.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.88 / $25.56 / $41.15	Professional	26	$17.88	$25.56	$41.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.86 / $30.77 / $89.28	Professional	TC	$20.86	$30.77	$89.28