Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.97 / $11.10 / $32.96	Facility	26	$9.97	$11.10	$32.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.48 / $38.77 / $167.00	Professional		$28.48	$38.77	$167.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.97 / $13.66 / $62.00	Professional	26	$9.97	$13.66	$62.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.48 / $21.58 / $34.51	Professional	TC	$18.48	$21.58	$34.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.86 / $44.78 / $45.22	Professional		$25.86	$44.78	$45.22
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $19.07 / $19.57	Professional	26	$10.83	$19.07	$19.57
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $38.61 / $46.01	Professional		$38.61	$38.61	$46.01
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $29.45 / $47.88 / $70.69	Professional		$29.45	$47.88	$70.69
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $10.38 / $17.68 / $26.82	Professional	26	$10.38	$17.68	$26.82
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $19.07 / $31.06 / $45.16	Professional	TC	$19.07	$31.06	$45.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.90 / $11.90 / $11.90	Facility	26	$11.90	$11.90	$11.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.93 / $41.17 / $66.05	Professional		$27.93	$41.17	$66.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $16.10 / $26.42	Professional	26	$9.78	$16.10	$26.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.26 / $25.27 / $42.27	Professional	TC	$18.26	$25.27	$42.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $35.47 / $45.83 / $61.06	Professional		$35.47	$45.83	$61.06
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $15.03 / $21.24	Professional	26	$11.72	$15.03	$21.24
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.67 / $30.77 / $39.82	Professional	TC	$23.67	$30.77	$39.82
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.63 / $12.95 / $12.95	Professional	26	$11.63	$12.95	$12.95
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $38.61 / $46.01	Professional		$38.61	$38.61	$46.01
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $11.10 / $11.10 / $32.96	Facility	26	$11.10	$11.10	$32.96
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $28.66 / $44.13 / $167.00	Professional		$28.66	$44.13	$167.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $10.06 / $15.50 / $61.55	Professional	26	$10.06	$15.50	$61.55
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $18.51 / $23.74 / $47.72	Professional	TC	$18.51	$23.74	$47.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.80 / $82.10 / $160.60	Professional		$64.80	$82.10	$160.60
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $11.90 / $11.90 / $11.90	Facility	26	$11.90	$11.90	$11.90
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $27.78 / $40.92 / $69.34	Professional		$27.78	$40.92	$69.34
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $16.26 / $26.64	Professional	26	$9.78	$16.26	$26.64
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.26 / $24.92 / $45.17	Professional	TC	$18.26	$24.92	$45.17
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $10.27 / $10.27 / $15.84	Facility	26	$10.27	$10.27	$15.84
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $29.23 / $37.79	Professional		$28.84	$29.23	$37.79
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $10.27 / $15.84	Professional	26	$10.02	$10.27	$15.84
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $18.59 / $18.96 / $21.95	Professional	TC	$18.59	$18.96	$21.95
United Facility/Professional Professional Modifier Low / Median / High Price $31.09 / $40.11 / $71.87	Professional		$31.09	$40.11	$71.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.48 / $15.31 / $27.06	Professional	26	$12.48	$15.31	$27.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.25 / $25.09 / $43.41	Professional	TC	$19.25	$25.09	$43.41