Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.60 / $20.05 / $69.34	Facility		$13.60	$20.05	$69.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $17.98 / $49.23	Facility	26	$10.36	$17.98	$49.23
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $11.32 / $32.63 / $92.19	Facility	TC	$11.32	$32.63	$92.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.48 / $18.39 / $34.08	Professional		$14.48	$18.39	$34.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.46 / $15.22 / $57.79	Professional	26	$9.46	$15.22	$57.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.87 / $6.90 / $12.02	Professional	TC	$5.87	$6.90	$12.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $8.99 / $8.99 / $9.43	Professional		$8.99	$8.99	$9.43
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.57 / $17.52 / $22.15	Professional	26	$5.57	$17.52	$22.15
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $12.08 / $12.60 / $16.11	Professional	26	$12.08	$12.60	$16.11
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $19.79 / $27.54 / $38.95	Facility		$19.79	$27.54	$38.95
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $19.79 / $27.54 / $38.95	Facility	TC	$19.79	$27.54	$38.95
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $19.98 / $29.22 / $39.49	Professional		$19.98	$29.22	$39.49
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $12.04 / $18.10 / $29.55	Professional	26	$12.04	$18.10	$29.55
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $6.08 / $8.25 / $15.91	Professional	TC	$6.08	$8.25	$15.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $14.15 / $14.15 / $34.44	Facility		$14.15	$14.15	$34.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.16 / $21.16 / $21.16	Facility	26	$21.16	$21.16	$21.16
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $13.30 / $13.30 / $13.30	Facility	TC	$13.30	$13.30	$13.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.41 / $11.69 / $27.60	Professional		$8.41	$11.69	$27.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.57 / $7.53 / $17.50	Professional	26	$5.57	$7.53	$17.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.79 / $4.30 / $10.11	Professional	TC	$2.79	$4.30	$10.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $12.77 / $29.08 / $39.02	Professional		$12.77	$29.08	$39.02
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.42 / $16.72 / $22.24	Professional	26	$7.42	$16.72	$22.24
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $5.36 / $12.35 / $16.78	Professional	TC	$5.36	$12.35	$16.78
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.74 / $21.52 / $21.94	Professional		$20.74	$21.52	$21.94
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $14.04 / $20.89	Professional	26	$12.30	$14.04	$20.89
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $5.79 / $5.82 / $5.97	Professional	TC	$5.79	$5.82	$5.97
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $12.08 / $12.60 / $16.11	Professional	26	$12.08	$12.60	$16.11
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $17.26 / $28.47 / $81.81	Facility		$17.26	$28.47	$81.81
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $10.36 / $17.98 / $49.23	Facility	26	$10.36	$17.98	$49.23
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $11.32 / $32.63 / $75.13	Facility	TC	$11.32	$32.63	$75.13
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $16.01 / $20.55 / $40.79	Professional		$16.01	$20.55	$40.79
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $9.86 / $17.98 / $57.79	Professional	26	$9.86	$17.98	$57.79
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $6.57 / $8.21 / $17.12	Professional	TC	$6.57	$8.21	$17.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.40 / $17.55 / $34.90	Professional		$9.40	$17.55	$34.90
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $14.15 / $14.15 / $34.44	Facility		$14.15	$14.15	$34.44
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $21.16 / $21.16 / $21.16	Facility	26	$21.16	$21.16	$21.16
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $13.30 / $13.30 / $13.30	Facility	TC	$13.30	$13.30	$13.30
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $8.68 / $13.98 / $29.87	Professional		$8.68	$13.98	$29.87
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.58 / $10.55 / $18.03	Professional	26	$5.58	$10.55	$18.03
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $2.86 / $4.54 / $11.77	Professional	TC	$2.86	$4.54	$11.77
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $16.70 / $19.80 / $25.00	Professional		$16.70	$19.80	$25.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.89 / $12.16 / $19.50	Professional	26	$11.89	$12.16	$19.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $3.75 / $7.80 / $8.69	Professional	TC	$3.75	$7.80	$8.69
United Facility/Professional Professional Modifier Low / Median / High Price $10.46 / $20.75 / $29.94	Professional		$10.46	$20.75	$29.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $12.73 / $20.79	Professional	26	$7.00	$12.73	$20.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $4.11 / $8.46 / $13.72	Professional	TC	$4.11	$8.46	$13.72