Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $43.65 / $83.18	Facility	26	$20.42	$43.65	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $67.61 / $204.17	Professional		$31.62	$67.61	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $44.67 / $117.49	Professional	26	$19.95	$44.67	$117.49
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $69.18 / $263.03	Professional	50	$36.31	$69.18	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.12 / $29.51 / $89.13	Professional	TC	$9.12	$29.51	$89.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $51.29 / $93.33	Professional		$41.69	$51.29	$93.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $30.90 / $54.95	Professional	26	$25.70	$30.90	$54.95
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	50	$79.43	$79.43	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $29.51 / $64.57	Professional	TC	$21.38	$29.51	$64.57
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $66.07 / $91.20	Professional		$61.66	$66.07	$91.20
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $33.88 / $54.95	Professional	26	$33.11	$33.88	$54.95
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $31.62 / $51.29	Professional	TC	$17.38	$31.62	$51.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $53.70	Facility	26	$7.94	$37.15	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $50.12 / $97.72	Professional		$30.90	$50.12	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $28.84 / $50.12	Professional	26	$19.50	$28.84	$50.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.77 / $17.38 / $51.29	Professional	TC	$9.77	$17.38	$51.29
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $89.13 / $107.15	Professional		$75.86	$89.13	$107.15
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $42.66 / $52.48	Professional	26	$27.54	$42.66	$52.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $43.65 / $54.95	Professional	TC	$28.18	$43.65	$54.95
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $66.07 / $104.71	Professional		$25.12	$66.07	$104.71
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $34.67 / $53.70	Professional	26	$16.98	$34.67	$53.70
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $7.76 / $29.51 / $51.29	Professional	TC	$7.76	$29.51	$51.29
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $77.62 / $89.13	Professional		$67.61	$77.62	$89.13
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $37.15 / $53.70	Professional	26	$29.51	$37.15	$53.70
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $77.62 / $95.50	Professional	50	$74.13	$77.62	$95.50
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $54.95 / $57.54	Professional	TC	$38.02	$54.95	$57.54
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $39.81 / $47.86	Professional	26	$33.11	$39.81	$47.86
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $40.74 / $83.18	Facility	26	$20.42	$40.74	$83.18
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $66.07 / $169.82	Professional		$31.62	$66.07	$169.82
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $38.90 / $89.13	Professional	26	$19.05	$38.90	$89.13
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $16.98 / $70.79 / $549.54	Professional	50	$16.98	$70.79	$549.54
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $9.55 / $30.20 / $69.18	Professional	TC	$9.55	$30.20	$69.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $64.57 / $117.49	Professional		$34.67	$64.57	$117.49
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $18.62 / $32.36	Facility	26	$18.62	$18.62	$32.36
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $41.69 / $87.10	Professional		$10.96	$41.69	$87.10
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $32.36 / $32.36	Professional	26	$18.62	$32.36	$32.36
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $8.71 / $9.12 / $9.77	Professional	TC	$8.71	$9.12	$9.77
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $54.95 / $87.10	Professional		$29.51	$54.95	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $25.12 / $42.66	Professional	26	$19.50	$25.12	$42.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $30.20 / $50.12	Professional	TC	$10.00	$30.20	$50.12