Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.88 / $11.67 / $30.82	Facility	26	$8.88	$11.67	$30.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.15 / $65.62 / $227.10	Professional		$32.15	$65.62	$227.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $10.11 / $28.93	Professional	26	$8.36	$10.11	$28.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.03 / $40.65 / $99.94	Professional	TC	$23.03	$40.65	$99.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.36 / $30.90 / $57.36	Professional		$26.36	$30.90	$57.36
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.13 / $10.11 / $15.49	Professional	26	$7.13	$10.11	$15.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.01 / $44.50 / $44.50	Professional	TC	$22.01	$44.50	$44.50
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $39.94 / $44.10 / $455.95	Professional		$39.94	$44.10	$455.95
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $10.91 / $99.81	Professional	26	$9.78	$10.91	$99.81
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $40.15 / $48.31 / $75.19	Professional		$40.15	$48.31	$75.19
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $9.93 / $11.93 / $18.98	Professional	26	$9.93	$11.93	$18.98
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $30.23 / $35.88 / $55.64	Professional	TC	$30.23	$35.88	$55.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.06 / $65.80 / $154.22	Professional		$32.06	$65.80	$154.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.82 / $12.03 / $18.77	Professional	26	$6.82	$12.03	$18.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.60 / $53.97 / $130.91	Professional	TC	$25.60	$53.97	$130.91
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $46.12 / $59.63 / $121.07	Professional		$46.12	$59.63	$121.07
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.29 / $12.34 / $19.47	Professional	26	$10.29	$12.34	$19.47
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.26 / $42.59 / $60.63	Professional	TC	$34.26	$42.59	$60.63
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.89 / $47.55 / $56.18	Professional		$43.89	$47.55	$56.18
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.50 / $11.63 / $33.68	Professional	26	$10.50	$11.63	$33.68
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.40 / $52.08 / $52.71	Professional	TC	$43.40	$52.08	$52.71
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $39.94 / $44.10 / $455.95	Professional		$39.94	$44.10	$455.95
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $9.39 / $10.91 / $99.81	Professional	26	$9.39	$10.91	$99.81
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $8.46 / $12.05 / $29.61	Facility	26	$8.46	$12.05	$29.61
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $32.43 / $55.08 / $224.11	Professional		$32.43	$55.08	$224.11
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $8.49 / $11.37 / $27.85	Professional	26	$8.49	$11.37	$27.85
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $23.70 / $40.65 / $108.34	Professional	TC	$23.70	$40.65	$108.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.57 / $40.84 / $167.50	Professional		$10.57	$40.84	$167.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $10.80 / $10.80 / $10.80	Facility	26	$10.80	$10.80	$10.80
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $64.45 / $154.22	Professional		$32.11	$64.45	$154.22
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.14 / $12.16 / $19.09	Professional	26	$7.14	$12.16	$19.09
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.60 / $52.42 / $128.31	Professional	TC	$25.60	$52.42	$128.31
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $9.30 / $9.30 / $32.00	Facility	26	$9.30	$9.30	$32.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $35.93 / $36.47 / $120.00	Professional		$35.93	$36.47	$120.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.06 / $9.30 / $32.00	Professional	26	$9.06	$9.30	$32.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.63 / $27.18 / $88.00	Professional	TC	$26.63	$27.18	$88.00
United Facility/Professional Professional Modifier Low / Median / High Price $30.34 / $50.02 / $97.34	Professional		$30.34	$50.02	$97.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.96 / $11.00 / $18.80	Professional	26	$6.96	$11.00	$18.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.70 / $35.94 / $72.88	Professional	TC	$21.70	$35.94	$72.88