Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.94 / $31.15 / $56.79	Facility	26	$25.94	$31.15	$56.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.18 / $57.20 / $227.21	Professional		$46.18	$57.20	$227.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.87 / $30.44 / $117.36	Professional	26	$24.87	$30.44	$117.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.26 / $68.23 / $285.00	Professional	52	$14.26	$68.23	$285.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $25.57 / $134.00	Professional	TC	$19.80	$25.57	$134.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.33 / $43.19 / $96.98	Professional		$38.33	$43.19	$96.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.51 / $29.38 / $47.04	Professional	26	$21.51	$29.38	$47.04
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $9.47 / $24.25 / $36.03	Professional	52	$9.47	$24.25	$36.03
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $35.54 / $40.46	Professional	TC	$19.64	$35.54	$40.46
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $56.61 / $62.54 / $89.99	Professional		$56.61	$62.54	$89.99
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $30.12 / $34.42 / $147.26	Professional	26	$30.12	$34.42	$147.26
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $51.40 / $84.00 / $100.11	Professional		$51.40	$84.00	$100.11
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $28.51 / $46.71 / $55.68	Professional	26	$28.51	$46.71	$55.68
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $22.89 / $37.07 / $45.39	Professional	TC	$22.89	$37.07	$45.39
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.71 / $65.67 / $103.86	Professional		$38.71	$65.67	$103.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.86 / $36.08 / $57.46	Professional	26	$20.86	$36.08	$57.46
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.22 / $30.03 / $46.90	Professional	TC	$18.22	$30.03	$46.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $58.61 / $71.01 / $90.03	Professional		$58.61	$71.01	$90.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $31.24 / $37.49 / $59.11	Professional	26	$31.24	$37.49	$59.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.37 / $34.10 / $48.62	Professional	TC	$27.37	$34.10	$48.62
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.36 / $58.60 / $73.59	Professional		$56.36	$58.60	$73.59
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.82 / $32.21 / $46.85	Professional	26	$29.82	$32.21	$46.85
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $15.18 / $16.50 / $35.00	Professional	52	$15.18	$16.50	$35.00
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.66 / $33.82 / $40.58	Professional	TC	$31.66	$33.82	$40.58
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $56.61 / $58.87 / $89.99	Professional		$56.61	$58.87	$89.99
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $29.99 / $33.09 / $147.26	Professional	26	$29.99	$33.09	$147.26
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $25.94 / $35.79 / $89.49	Facility	26	$25.94	$35.79	$89.49
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $46.35 / $61.00 / $220.59	Professional		$46.35	$61.00	$220.59
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $25.94 / $36.04 / $84.11	Professional	26	$25.94	$36.04	$84.11
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $14.26 / $61.49 / $231.00	Professional	52	$14.26	$61.49	$231.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $20.23 / $28.28 / $94.29	Professional	TC	$20.23	$28.28	$94.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.50 / $43.57 / $85.54	Professional		$23.50	$43.57	$85.54
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $32.40 / $32.40 / $32.40	Facility	26	$32.40	$32.40	$32.40
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $39.83 / $65.45 / $105.63	Professional		$39.83	$65.45	$105.63
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.31 / $36.27 / $57.46	Professional	26	$21.31	$36.27	$57.46
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.71 / $29.89 / $46.90	Professional	TC	$18.71	$29.89	$46.90
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $28.52 / $28.52 / $32.79	Facility	26	$28.52	$28.52	$32.79
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $50.40 / $51.28 / $59.14	Professional		$50.40	$51.28	$59.14
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $27.74 / $28.57 / $32.79	Professional	26	$27.74	$28.57	$32.79
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.25 / $22.76 / $26.33	Professional	TC	$22.25	$22.76	$26.33
United Facility/Professional Professional Modifier Low / Median / High Price $48.42 / $63.49 / $102.68	Professional		$48.42	$63.49	$102.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.12 / $34.65 / $56.42	Professional	26	$27.12	$34.65	$56.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.46 / $28.69 / $44.66	Professional	TC	$21.46	$28.69	$44.66