Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.32 / $17.82 / $51.16	Facility	26	$4.32	$17.82	$51.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.83 / $104.50 / $223.63	Professional		$81.83	$104.50	$223.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.83 / $19.07 / $59.46	Professional	26	$15.83	$19.07	$59.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $68.59 / $87.32 / $141.25	Professional	TC	$68.59	$87.32	$141.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.06 / $72.06 / $79.98	Professional		$72.06	$72.06	$79.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $14.27 / $25.48 / $33.33	Professional	26	$14.27	$25.48	$33.33
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $18.97 / $21.02 / $587.40	Professional	26	$18.97	$21.02	$587.40
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $93.44 / $108.79 / $157.74	Professional		$93.44	$108.79	$157.74
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $18.12 / $23.24 / $35.40	Professional	26	$18.12	$23.24	$35.40
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $75.31 / $85.20 / $128.94	Professional	TC	$75.31	$85.20	$128.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.50 / $20.50 / $20.50	Facility	26	$20.50	$20.50	$20.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.23 / $113.40 / $183.93	Professional		$68.23	$113.40	$183.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.35 / $22.45 / $36.15	Professional	26	$13.35	$22.45	$36.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.56 / $88.84 / $150.35	Professional	TC	$52.56	$88.84	$150.35
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $101.20 / $133.59 / $152.24	Professional		$101.20	$133.59	$152.24
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.97 / $23.70 / $27.38	Professional	26	$19.97	$23.70	$27.38
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $90.14 / $112.25 / $124.87	Professional	TC	$90.14	$112.25	$124.87
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.75 / $106.89 / $108.69	Professional		$102.75	$106.89	$108.69
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.36 / $21.07 / $30.65	Professional	26	$18.36	$21.07	$30.65
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $18.96 / $20.60 / $37.65	Professional	26	$18.96	$20.60	$37.65
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $17.82 / $26.54 / $57.06	Facility	26	$17.82	$26.54	$57.06
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $84.67 / $116.34 / $223.63	Professional		$84.67	$116.34	$223.63
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $16.27 / $23.81 / $52.95	Professional	26	$16.27	$23.81	$52.95
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $73.38 / $95.93 / $172.45	Professional	TC	$73.38	$95.93	$172.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.23 / $87.80 / $177.61	Professional		$19.23	$87.80	$177.61
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $20.50 / $20.50 / $20.50	Facility	26	$20.50	$20.50	$20.50
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $70.86 / $111.51 / $184.50	Professional		$70.86	$111.51	$184.50
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.64 / $22.45 / $36.18	Professional	26	$13.64	$22.45	$36.18
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $56.03 / $88.84 / $151.65	Professional	TC	$56.03	$88.84	$151.65
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $17.57 / $17.57 / $19.71	Facility	26	$17.57	$17.57	$19.71
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $94.72 / $96.30 / $104.89	Professional		$94.72	$96.30	$104.89
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $17.01 / $17.72 / $19.71	Professional	26	$17.01	$17.72	$19.71
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $77.00 / $78.72 / $86.66	Professional	TC	$77.00	$78.72	$86.66
United Facility/Professional Professional Modifier Low / Median / High Price $78.05 / $100.69 / $174.93	Professional		$78.05	$100.69	$174.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.89 / $20.48 / $34.64	Professional	26	$16.89	$20.48	$34.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.36 / $82.16 / $139.37	Professional	TC	$66.36	$82.16	$139.37