Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.17 / $3.42 / $5.37	Facility	26	$3.17	$3.42	$5.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.83 / $41.83 / $123.51	Professional		$21.83	$41.83	$123.51
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.86 / $4.38 / $14.99	Professional	26	$2.86	$4.38	$14.99
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.68 / $11.79 / $30.28	Professional	52	$9.68	$11.79	$30.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.94 / $29.91 / $82.00	Professional	TC	$18.94	$29.91	$82.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.98 / $21.18 / $21.64	Professional		$19.98	$21.18	$21.64
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $4.20 / $4.66 / $5.72	Professional	26	$4.20	$4.66	$5.72
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $3.57 / $3.89 / $4.05	Professional	26	$3.57	$3.89	$4.05
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $21.79 / $36.51 / $216.22	Professional		$21.79	$36.51	$216.22
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $3.03 / $4.91 / $7.91	Professional	26	$3.03	$4.91	$7.91
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $18.75 / $31.59 / $208.32	Professional	TC	$18.75	$31.59	$208.32
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.49 / $3.49 / $3.49	Facility	26	$3.49	$3.49	$3.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.94 / $42.43 / $142.21	Professional		$22.94	$42.43	$142.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.95 / $4.50 / $7.07	Professional	26	$2.95	$4.50	$7.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.98 / $38.96 / $133.88	Professional	TC	$19.98	$38.96	$133.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $29.40 / $59.78 / $71.48	Professional		$29.40	$59.78	$71.48
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.59 / $4.32 / $8.74	Professional	26	$3.59	$4.32	$8.74
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.45 / $31.01 / $62.75	Professional	TC	$24.45	$31.01	$62.75
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.82 / $28.42 / $69.64	Professional		$24.82	$28.42	$69.64
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.38 / $3.90 / $131.00	Professional	26	$3.38	$3.90	$131.00
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.43 / $69.43 / $115.97	Professional	TC	$69.43	$69.43	$115.97
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $3.74 / $3.89 / $6.40	Professional	26	$3.74	$3.89	$6.40
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $3.17 / $4.53 / $17.07	Facility	26	$3.17	$4.53	$17.07
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $22.92 / $45.70 / $114.60	Professional		$22.92	$45.70	$114.60
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $2.89 / $4.88 / $13.59	Professional	26	$2.89	$4.88	$13.59
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $9.52 / $11.94 / $30.28	Professional	52	$9.52	$11.94	$30.28
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $18.94 / $33.19 / $73.15	Professional	TC	$18.94	$33.19	$73.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.09 / $38.94 / $145.60	Professional		$5.09	$38.94	$145.60
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $3.49 / $3.49 / $3.49	Facility	26	$3.49	$3.49	$3.49
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $22.61 / $36.32 / $134.61	Professional		$22.61	$36.32	$134.61
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2.95 / $4.48 / $7.15	Professional	26	$2.95	$4.48	$7.15
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.91 / $33.70 / $132.37	Professional	TC	$19.91	$33.70	$132.37
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $3.00 / $3.00 / $5.62	Facility	26	$3.00	$3.00	$5.62
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $21.84 / $22.29 / $105.78	Professional		$21.84	$22.29	$105.78
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $2.94 / $3.00 / $5.62	Professional	26	$2.94	$3.00	$5.62
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $18.85 / $19.29 / $100.16	Professional	TC	$18.85	$19.29	$100.16
United Facility/Professional Professional Modifier Low / Median / High Price $23.83 / $35.70 / $115.97	Professional		$23.83	$35.70	$115.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.06 / $4.20 / $6.32	Professional	26	$3.06	$4.20	$6.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.63 / $29.78 / $92.64	Professional	TC	$20.63	$29.78	$92.64