Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.48 / $27.90 / $42.80	Facility	26	$24.48	$27.90	$42.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.43 / $135.83 / $477.00	Professional		$93.43	$135.83	$477.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.14 / $33.76 / $110.00	Professional	26	$23.14	$33.76	$110.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.48 / $86.57 / $137.19	Professional	TC	$67.48	$86.57	$137.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.40 / $91.47 / $91.47	Professional		$72.40	$91.47	$91.47
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.22 / $37.02 / $46.28	Professional	26	$34.22	$37.02	$46.28
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $28.98 / $31.65 / $33.17	Professional	26	$28.98	$31.65	$33.17
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $94.14 / $146.94 / $221.03	Professional		$94.14	$146.94	$221.03
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $24.53 / $39.75 / $61.54	Professional	26	$24.53	$39.75	$61.54
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $69.61 / $105.89 / $173.15	Professional	TC	$69.61	$105.89	$173.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.20 / $28.20 / $28.20	Facility	26	$28.20	$28.20	$28.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.96 / $133.21 / $218.57	Professional		$97.96	$133.21	$218.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.09 / $33.60 / $53.90	Professional	26	$24.09	$33.60	$53.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.67 / $101.45 / $161.75	Professional	TC	$74.67	$101.45	$161.75
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $120.70 / $148.86 / $306.74	Professional		$120.70	$148.86	$306.74
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.33 / $35.26 / $72.56	Professional	26	$29.33	$35.26	$72.56
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $90.57 / $113.61 / $234.19	Professional	TC	$90.57	$113.61	$234.19
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $336.80 / $429.45 / $557.49	Facility	26	$336.80	$429.45	$557.49
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.70 / $33.07 / $37.63	Professional	26	$29.70	$33.07	$37.63
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $30.52 / $31.75 / $52.09	Professional	26	$30.52	$31.75	$52.09
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $23.32 / $33.35 / $82.86	Facility	26	$23.32	$33.35	$82.86
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $97.11 / $164.28 / $426.00	Professional		$97.11	$164.28	$426.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $23.32 / $36.65 / $83.53	Professional	26	$23.32	$36.65	$83.53
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $67.48 / $95.74 / $195.00	Professional	TC	$67.48	$95.74	$195.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $132.69 / $210.90	Professional		$39.90	$132.69	$210.90
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $28.20 / $28.20 / $28.20	Facility	26	$28.20	$28.20	$28.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $97.76 / $132.41 / $219.20	Professional		$97.76	$132.41	$219.20
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.09 / $33.26 / $57.15	Professional	26	$24.09	$33.26	$57.15
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $73.80 / $100.25 / $158.91	Professional	TC	$73.80	$100.25	$158.91
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $24.27 / $24.27 / $30.50	Facility	26	$24.27	$24.27	$30.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $92.65 / $94.12 / $113.00	Professional		$92.65	$94.12	$113.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $23.68 / $24.27 / $30.50	Professional	26	$23.68	$24.27	$30.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $68.40 / $69.84 / $82.50	Professional	TC	$68.40	$69.84	$82.50
United Facility/Professional Professional Modifier Low / Median / High Price $95.58 / $126.84 / $204.65	Professional		$95.58	$126.84	$204.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.74 / $32.90 / $51.16	Professional	26	$24.74	$32.90	$51.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.67 / $92.56 / $146.06	Professional	TC	$69.67	$92.56	$146.06