Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.56 / $26.72 / $49.09	Facility	26	$20.56	$26.72	$49.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.28 / $56.85 / $192.79	Professional		$28.28	$56.85	$192.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $32.51 / $101.76	Professional	26	$17.80	$32.51	$101.76
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.77 / $69.77 / $69.90	Professional	50	$69.77	$69.77	$69.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.18 / $27.01 / $70.00	Professional	TC	$9.18	$27.01	$70.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $43.83 / $51.88 / $119.00	Professional		$43.83	$51.88	$119.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.94 / $34.11 / $51.42	Professional	26	$24.94	$34.11	$51.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.23 / $23.23 / $46.98	Professional	TC	$23.23	$23.23	$46.98
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $53.02 / $70.53 / $90.33	Professional		$53.02	$70.53	$90.33
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $34.56 / $40.98 / $67.88	Professional	26	$34.56	$40.98	$67.88
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $62.28 / $65.45 / $102.20	Professional		$62.28	$65.45	$102.20
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $32.86 / $39.24 / $55.46	Professional	26	$32.86	$39.24	$55.46
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $14.48 / $30.20 / $50.35	Professional	TC	$14.48	$30.20	$50.35
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $37.43 / $37.43	Facility	26	$37.43	$37.43	$37.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.72 / $51.34 / $99.45	Professional		$32.72	$51.34	$99.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.20 / $30.81 / $52.12	Professional	26	$20.20	$30.81	$52.12
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.87 / $74.87 / $84.74	Professional	50	$74.87	$74.87	$84.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.66 / $18.54 / $50.72	Professional	TC	$10.66	$18.54	$50.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $33.65 / $88.16 / $151.94	Professional		$33.65	$88.16	$151.94
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $37.32 / $47.71 / $74.78	Professional	26	$37.32	$47.71	$74.78
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.79 / $48.59 / $77.17	Professional	TC	$37.79	$48.59	$77.17
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.37 / $75.64 / $84.68	Professional		$67.37	$75.64	$84.68
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.27 / $38.83 / $56.02	Professional	26	$16.27	$38.83	$56.02
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $74.11 / $74.11 / $78.40	Professional	50	$74.11	$74.11	$78.40
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $34.88 / $45.35 / $56.29	Professional	TC	$34.88	$45.35	$56.29
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $53.02 / $66.51 / $87.54	Professional		$53.02	$66.51	$87.54
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $32.89 / $39.77 / $67.66	Professional	26	$32.89	$39.77	$67.66
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $20.55 / $29.24 / $64.40	Facility	26	$20.55	$29.24	$64.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $29.01 / $65.59 / $178.00	Professional		$29.01	$65.59	$178.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $19.39 / $36.22 / $83.86	Professional	26	$19.39	$36.22	$83.86
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $69.77 / $69.90 / $127.84	Professional	50	$69.77	$69.90	$127.84
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $10.42 / $31.48 / $72.33	Professional	TC	$10.42	$31.48	$72.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.48 / $40.29 / $118.40	Professional		$31.48	$40.29	$118.40
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $37.43 / $37.43	Facility	26	$37.43	$37.43	$37.43
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $33.51 / $52.10 / $99.45	Professional		$33.51	$52.10	$99.45
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.43 / $31.19 / $50.25	Professional	26	$21.43	$31.19	$50.25
Priority Health Facility/Professional Professional Modifier 50 Low / Median / High Price $74.87 / $84.74 / $84.74	Professional	50	$74.87	$84.74	$84.74
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $10.70 / $19.61 / $51.64	Professional	TC	$10.70	$19.61	$51.64
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $18.53 / $32.51 / $32.51	Facility	26	$18.53	$32.51	$32.51
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $30.40 / $41.25 / $43.47	Professional		$30.40	$41.25	$43.47
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $18.53 / $32.54 / $33.72	Professional	26	$18.53	$32.54	$33.72
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $8.69 / $9.02 / $32.65	Professional	TC	$8.69	$9.02	$32.65
United Facility/Professional Professional Modifier Low / Median / High Price $29.54 / $56.13 / $100.70	Professional		$29.54	$56.13	$100.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.57 / $26.91 / $46.24	Professional	26	$19.57	$26.91	$46.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.89 / $31.21 / $57.42	Professional	TC	$10.89	$31.21	$57.42