Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.38 / $10.71 / $17.59	Facility	26	$10.38	$10.71	$17.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.19 / $62.77 / $176.58	Professional		$36.19	$62.77	$176.58
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $13.76 / $13.76 / $13.86	Professional	25	$13.76	$13.76	$13.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.68 / $14.26 / $49.00	Professional	26	$9.68	$14.26	$49.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.22 / $38.29 / $61.46	Professional	TC	$26.22	$38.29	$61.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.07 / $36.15 / $57.95	Professional		$33.07	$36.15	$57.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $12.39 / $16.57	Professional	26	$8.66	$12.39	$16.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $23.48 / $23.48 / $24.23	Professional	TC	$23.48	$23.48	$24.23
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $48.60 / $52.77 / $69.80	Professional		$48.60	$52.77	$69.80
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $11.11 / $12.56 / $16.38	Professional	26	$11.11	$12.56	$16.38
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $37.74 / $54.43 / $115.98	Professional		$37.74	$54.43	$115.98
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $10.08 / $14.60 / $29.02	Professional	26	$10.08	$14.60	$29.02
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $27.66 / $39.44 / $83.77	Professional	TC	$27.66	$39.44	$83.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.84 / $62.69 / $106.87	Professional		$38.84	$62.69	$106.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.19 / $15.42 / $25.25	Professional	26	$10.19	$15.42	$25.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.70 / $47.11 / $81.31	Professional	TC	$28.70	$47.11	$81.31
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $42.08 / $59.04 / $90.93	Professional		$42.08	$59.04	$90.93
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $14.47 / $20.62	Professional	26	$11.07	$14.47	$20.62
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.03 / $44.51 / $70.65	Professional	TC	$31.03	$44.51	$70.65
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.52 / $48.71 / $68.56	Professional		$43.52	$48.71	$68.56
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.16 / $13.60 / $30.41	Professional	26	$11.16	$13.60	$30.41
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.59 / $32.36 / $32.40	Professional	TC	$30.59	$32.36	$32.40
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $48.60 / $54.43 / $85.21	Professional		$48.60	$54.43	$85.21
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $11.73 / $21.41	Professional	26	$10.47	$11.73	$21.41
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $9.89 / $12.85 / $17.73	Facility	26	$9.89	$12.85	$17.73
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $36.64 / $64.06 / $149.82	Professional		$36.64	$64.06	$149.82
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $9.78 / $15.07 / $40.42	Professional	26	$9.78	$15.07	$40.42
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.78 / $40.04 / $78.40	Professional	TC	$26.78	$40.04	$78.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.74 / $69.97 / $121.35	Professional		$14.74	$69.97	$121.35
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $11.60 / $11.60 / $11.60	Facility	26	$11.60	$11.60	$11.60
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $38.15 / $62.44 / $109.79	Professional		$38.15	$62.44	$109.79
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.99 / $15.09 / $25.72	Professional	26	$9.99	$15.09	$25.72
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.01 / $47.00 / $81.90	Professional	TC	$28.01	$47.00	$81.90
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $9.98 / $9.98 / $24.77	Facility	26	$9.98	$9.98	$24.77
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $36.29 / $36.84 / $69.84	Professional		$36.29	$36.84	$69.84
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.72 / $9.98 / $24.77	Professional	26	$9.72	$9.98	$24.77
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.32 / $26.87 / $45.08	Professional	TC	$26.32	$26.87	$45.08
United Facility/Professional Professional Modifier Low / Median / High Price $46.42 / $60.93 / $103.52	Professional		$46.42	$60.93	$103.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.48 / $13.82 / $23.50	Professional	26	$10.48	$13.82	$23.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.31 / $46.92 / $83.40	Professional	TC	$34.31	$46.92	$83.40