Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.86 / $40.04 / $118.91	Facility	26	$36.86	$40.04	$118.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.66 / $224.00 / $943.00	Professional		$133.66	$224.00	$943.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.11 / $60.22 / $198.36	Professional	26	$36.11	$60.22	$198.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $96.93 / $159.04 / $280.58	Professional	TC	$96.93	$159.04	$280.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.91 / $117.25 / $157.03	Professional		$100.91	$117.25	$157.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $28.00 / $32.61 / $57.73	Professional	26	$28.00	$32.61	$57.73
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.66 / $162.66 / $182.60	Professional	TC	$162.66	$162.66	$182.60
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $39.47 / $43.63 / $107.30	Professional	26	$39.47	$43.63	$107.30
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $142.16 / $201.67 / $361.91	Professional		$142.16	$201.67	$361.91
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $37.60 / $60.92 / $120.16	Professional	26	$37.60	$60.92	$120.16
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $104.57 / $147.25 / $254.37	Professional	TC	$104.57	$147.25	$254.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.24 / $43.24 / $43.24	Facility	26	$43.24	$43.24	$43.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $146.99 / $233.18 / $369.83	Professional		$146.99	$233.18	$369.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.59 / $61.36 / $98.93	Professional	26	$35.59	$61.36	$98.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.38 / $174.96 / $270.89	Professional	TC	$115.38	$174.96	$270.89
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $182.35 / $229.22 / $463.85	Professional		$182.35	$229.22	$463.85
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $45.10 / $55.38 / $112.07	Professional	26	$45.10	$55.38	$112.07
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $136.05 / $173.84 / $351.79	Professional	TC	$136.05	$173.84	$351.79
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $168.79 / $179.11 / $239.74	Professional		$168.79	$179.11	$239.74
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.01 / $49.68 / $70.48	Professional	26	$42.01	$49.68	$70.48
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $150.19 / $150.19 / $177.51	Professional	TC	$150.19	$150.19	$177.51
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $39.15 / $42.51 / $107.30	Professional	26	$39.15	$42.51	$107.30
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $254.72 / $254.72 / $254.72	Professional		$254.72	$254.72	$254.72
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $36.86 / $53.46 / $124.52	Facility	26	$36.86	$53.46	$124.52
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $135.47 / $232.99 / $771.40	Professional		$135.47	$232.99	$771.40
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $36.85 / $63.40 / $173.30	Professional	26	$36.85	$63.40	$173.30
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $99.37 / $162.12 / $317.58	Professional	TC	$99.37	$162.12	$317.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $49.66 / $200.87 / $311.00	Professional		$49.66	$200.87	$311.00
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $43.24 / $43.24 / $43.24	Facility	26	$43.24	$43.24	$43.24
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $146.25 / $232.59 / $368.12	Professional		$146.25	$232.59	$368.12
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.59 / $60.20 / $103.52	Professional	26	$35.59	$60.20	$103.52
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $115.38 / $172.80 / $278.79	Professional	TC	$115.38	$172.80	$278.79
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $37.19 / $37.19 / $61.24	Facility	26	$37.19	$37.19	$61.24
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $134.97 / $138.08 / $213.52	Professional		$134.97	$138.08	$213.52
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $36.24 / $37.20 / $61.24	Professional	26	$36.24	$37.20	$61.24
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $97.76 / $101.84 / $152.28	Professional	TC	$97.76	$101.84	$152.28
United Facility/Professional Professional Modifier Low / Median / High Price $150.84 / $198.48 / $319.64	Professional		$150.84	$198.48	$319.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.06 / $52.09 / $81.55	Professional	26	$36.06	$52.09	$81.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $113.65 / $147.03 / $243.56	Professional	TC	$113.65	$147.03	$243.56