Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.50 / $35.69 / $61.15	Facility	26	$28.50	$35.69	$61.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.67 / $134.59 / $585.14	Professional		$78.67	$134.59	$585.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $45.22 / $136.21	Professional	26	$27.23	$45.22	$136.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.46 / $84.53 / $165.87	Professional	TC	$49.46	$84.53	$165.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.18 / $78.25 / $171.69	Professional		$60.18	$78.25	$171.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $22.59 / $31.16 / $52.41	Professional	26	$22.59	$31.16	$52.41
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $54.30 / $103.34 / $116.01	Professional	TC	$54.30	$103.34	$116.01
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $33.79 / $41.45 / $73.62	Professional	26	$33.79	$41.45	$73.62
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $96.63 / $100.28 / $203.19	Professional		$96.63	$100.28	$203.19
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $30.21 / $49.46 / $74.45	Professional	26	$30.21	$49.46	$74.45
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $62.20 / $68.94 / $128.77	Professional	TC	$62.20	$68.94	$128.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $34.36 / $34.36	Facility	26	$34.36	$34.36	$34.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $122.63 / $200.23	Professional		$74.84	$122.63	$200.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.22 / $39.06 / $61.35	Professional	26	$24.22	$39.06	$61.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.62 / $83.20 / $137.53	Professional	TC	$47.62	$83.20	$137.53
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $116.59 / $138.61 / $237.97	Professional		$116.59	$138.61	$237.97
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.22 / $43.65 / $68.29	Professional	26	$34.22	$43.65	$68.29
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $83.10 / $106.84 / $169.69	Professional	TC	$83.10	$106.84	$169.69
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.53 / $119.42 / $145.15	Professional		$112.53	$119.42	$145.15
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.38 / $38.64 / $53.34	Professional	26	$33.38	$38.64	$53.34
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $87.07 / $102.90 / $123.85	Professional	TC	$87.07	$102.90	$123.85
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $31.75 / $41.45 / $59.50	Professional	26	$31.75	$41.45	$59.50
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $102.71 / $102.71 / $102.71	Professional		$102.71	$102.71	$102.71
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $27.46 / $39.22 / $87.23	Facility	26	$27.46	$39.22	$87.23
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $86.28 / $137.65 / $503.53	Professional		$86.28	$137.65	$503.53
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $27.82 / $46.04 / $115.89	Professional	26	$27.82	$46.04	$115.89
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $58.70 / $92.46 / $176.31	Professional	TC	$58.70	$92.46	$176.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $42.24 / $114.10 / $235.50	Professional		$42.24	$114.10	$235.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $34.36 / $34.36 / $34.36	Facility	26	$34.36	$34.36	$34.36
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $121.39 / $200.23	Professional		$74.84	$121.39	$200.23
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.66 / $38.83 / $61.35	Professional	26	$24.66	$38.83	$61.35
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.45 / $83.03 / $137.28	Professional	TC	$46.45	$83.03	$137.28
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $30.19 / $30.19 / $37.00	Facility	26	$30.19	$30.19	$37.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $96.12 / $97.52 / $113.00	Professional		$96.12	$97.52	$113.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.38 / $30.24 / $37.00	Professional	26	$29.38	$30.24	$37.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $65.88 / $67.33 / $76.00	Professional	TC	$65.88	$67.33	$76.00
United Facility/Professional Professional Modifier Low / Median / High Price $81.26 / $111.08 / $190.23	Professional		$81.26	$111.08	$190.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.81 / $34.25 / $58.88	Professional	26	$25.81	$34.25	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $55.73 / $80.29 / $130.97	Professional	TC	$55.73	$80.29	$130.97