Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.90 / $89.27 / $129.10	Facility		$25.90	$89.27	$129.10
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.74 / $9.98 / $27.30	Facility	26	$5.74	$9.98	$27.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.06 / $47.20 / $69.56	Professional		$24.06	$47.20	$69.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.40 / $10.27 / $31.47	Professional	26	$5.40	$10.27	$31.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.73 / $39.82 / $62.69	Professional	TC	$18.73	$39.82	$62.69
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.25 / $9.44 / $12.29	Professional	26	$3.25	$9.44	$12.29
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $6.73 / $7.03 / $8.99	Professional	26	$6.73	$7.03	$8.99
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $51.21 / $90.92	Professional		$32.11	$51.21	$90.92
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $6.68 / $10.83 / $17.25	Professional	26	$6.68	$10.83	$17.25
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $25.43 / $40.36 / $79.69	Professional	TC	$25.43	$40.36	$79.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.59 / $43.59 / $74.45	Facility		$43.59	$43.59	$74.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.31 / $9.31 / $9.31	Facility	26	$9.31	$9.31	$9.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.15 / $27.01 / $53.37	Professional		$15.15	$27.01	$53.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.14 / $4.16 / $10.01	Professional	26	$3.14	$4.16	$10.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.82 / $23.04 / $44.63	Professional	TC	$11.82	$23.04	$44.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $21.20 / $48.95 / $176.09	Professional		$21.20	$48.95	$176.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $4.13 / $9.27 / $29.03	Professional	26	$4.13	$9.27	$29.03
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.05 / $39.67 / $52.86	Professional	TC	$17.05	$39.67	$52.86
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $188.21 / $188.21 / $188.21	Facility		$188.21	$188.21	$188.21
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.43 / $32.02 / $35.97	Professional		$29.43	$32.02	$35.97
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.97 / $7.91 / $11.79	Professional	26	$6.97	$7.91	$11.79
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $6.73 / $7.03 / $8.99	Professional	26	$6.73	$7.03	$8.99
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $24.00 / $48.00 / $129.10	Facility		$24.00	$48.00	$129.10
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $5.74 / $9.98 / $27.30	Facility	26	$5.74	$9.98	$27.30
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $24.67 / $40.58 / $70.12	Professional		$24.67	$40.58	$70.12
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $5.47 / $11.03 / $29.21	Professional	26	$5.47	$11.03	$29.21
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $19.19 / $33.71 / $64.51	Professional	TC	$19.19	$33.71	$64.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $7.15 / $32.90 / $60.10	Professional		$7.15	$32.90	$60.10
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $43.59 / $43.59 / $74.45	Facility		$43.59	$43.59	$74.45
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $9.31 / $9.31 / $9.31	Facility	26	$9.31	$9.31	$9.31
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $15.15 / $28.94 / $56.07	Professional		$15.15	$28.94	$56.07
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.15 / $6.21 / $10.57	Professional	26	$3.15	$6.21	$10.57
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $11.85 / $23.27 / $47.10	Professional	TC	$11.85	$23.27	$47.10
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $30.78 / $31.26 / $47.48	Professional		$30.78	$31.26	$47.48
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $6.74 / $11.00	Professional	26	$6.61	$6.74	$11.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $23.78 / $24.65 / $36.47	Professional	TC	$23.78	$24.65	$36.47
United Facility/Professional Professional Modifier Low / Median / High Price $16.76 / $29.73 / $54.65	Professional		$16.76	$29.73	$54.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.85 / $6.99 / $12.24	Professional	26	$3.85	$6.99	$12.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.51 / $24.07 / $45.26	Professional	TC	$14.51	$24.07	$45.26