Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.78 / $82.39 / $159.87	Facility	26	$53.78	$82.39	$159.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.00 / $709.48 / $799.14	Professional		$152.00	$709.48	$799.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.46 / $257.12 / $266.93	Professional	26	$59.46	$257.12	$266.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.53 / $452.37 / $532.16	Professional	TC	$92.53	$452.37	$532.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.48 / $89.08 / $91.97	Professional		$87.48	$89.08	$91.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.82 / $64.17 / $83.42	Professional	26	$35.82	$64.17	$83.42
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $57.53 / $57.53 / $57.53	Professional	TC	$57.53	$57.53	$57.53
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $45.58 / $54.70 / $79.91	Professional	26	$45.58	$54.70	$79.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $122.47 / $142.00 / $210.99	Professional		$122.47	$142.00	$210.99
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $47.91 / $49.62 / $81.12	Professional	26	$47.91	$49.62	$81.12
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $74.56 / $88.23 / $130.44	Professional	TC	$74.56	$88.23	$130.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.20 / $232.67 / $389.47	Professional		$194.20	$232.67	$389.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.09 / $86.37 / $144.57	Professional	26	$72.09	$86.37	$144.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $122.11 / $146.31 / $244.90	Professional	TC	$122.11	$146.31	$244.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $134.61 / $184.69 / $418.58	Professional		$134.61	$184.69	$418.58
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $50.18 / $60.51 / $67.70	Professional	26	$50.18	$60.51	$67.70
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $84.44 / $105.15 / $116.99	Professional	TC	$84.44	$105.15	$116.99
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.96 / $145.01 / $193.58	Professional		$133.96	$145.01	$193.58
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.84 / $55.00 / $73.84	Professional	26	$48.84	$55.00	$73.84
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $82.99 / $82.99 / $112.66	Professional	TC	$82.99	$82.99	$112.66
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $45.58 / $48.77 / $79.91	Professional	26	$45.58	$48.77	$79.91
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $48.89 / $82.39 / $159.87	Facility	26	$48.89	$82.39	$159.87
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $112.14 / $155.28 / $709.48	Professional		$112.14	$155.28	$709.48
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $44.20 / $59.46 / $257.12	Professional	26	$44.20	$59.46	$257.12
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $79.45 / $99.86 / $452.37	Professional	TC	$79.45	$99.86	$452.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $67.62 / $151.32 / $260.80	Professional		$67.62	$151.32	$260.80
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $194.20 / $232.67 / $389.47	Professional		$194.20	$232.67	$389.47
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.09 / $86.37 / $144.57	Professional	26	$72.09	$86.37	$144.57
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $122.11 / $146.31 / $244.90	Professional	TC	$122.11	$146.31	$244.90
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $43.94 / $43.94 / $52.00	Facility	26	$43.94	$43.94	$52.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $114.36 / $116.02 / $160.02	Professional		$114.36	$116.02	$160.02
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.93 / $43.94 / $52.00	Professional	26	$42.93	$43.94	$52.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $70.51 / $72.08 / $108.02	Professional	TC	$70.51	$72.08	$108.02
United Facility/Professional Professional Modifier Low / Median / High Price $106.77 / $146.43 / $245.26	Professional		$106.77	$146.43	$245.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.79 / $50.81 / $83.59	Professional	26	$39.79	$50.81	$83.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.05 / $95.41 / $172.95	Professional	TC	$66.05	$95.41	$172.95