Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.55 / $12.48 / $20.69	Facility	26	$11.55	$12.48	$20.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.79 / $58.21 / $130.59	Professional		$49.79	$58.21	$130.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.93 / $13.97 / $51.09	Professional	26	$10.93	$13.97	$51.09
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.50 / $26.12 / $30.58	Professional	52	$22.50	$26.12	$30.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.39 / $42.49 / $66.92	Professional	TC	$36.39	$42.49	$66.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.64 / $57.78 / $83.97	Professional		$50.64	$57.78	$83.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $14.44 / $19.34	Professional	26	$10.11	$14.44	$19.34
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.65 / $37.65 / $37.65	Professional	TC	$37.65	$37.65	$37.65
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $57.26 / $57.26 / $76.41	Professional		$57.26	$57.26	$76.41
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $12.95 / $13.73 / $19.11	Professional	26	$12.95	$13.73	$19.11
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $54.69 / $56.75 / $100.60	Professional		$54.69	$56.75	$100.60
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $11.78 / $12.22 / $24.42	Professional	26	$11.78	$12.22	$24.42
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $42.91 / $44.53 / $75.98	Professional	TC	$42.91	$44.53	$75.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $68.56 / $107.64	Professional		$53.70	$68.56	$107.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.66 / $15.31 / $24.55	Professional	26	$11.66	$15.31	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.04 / $52.97 / $83.72	Professional	TC	$41.04	$52.97	$83.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $61.02 / $79.95 / $113.38	Professional		$61.02	$79.95	$113.38
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.93 / $16.86 / $21.94	Professional	26	$12.93	$16.86	$21.94
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.09 / $64.48 / $89.62	Professional	TC	$48.09	$64.48	$89.62
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.70 / $69.19 / $82.14	Professional		$63.70	$69.19	$82.14
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.03 / $14.73 / $19.82	Professional	26	$13.03	$14.73	$19.82
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $34.38 / $34.38 / $34.38	Professional	52	$34.38	$34.38	$34.38
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $57.26 / $57.26 / $76.41	Professional		$57.26	$57.26	$76.41
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $12.20 / $13.66 / $21.39	Professional	26	$12.20	$13.66	$21.39
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $11.55 / $14.88 / $24.71	Facility	26	$11.55	$14.88	$24.71
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $50.39 / $66.30 / $149.26	Professional		$50.39	$66.30	$149.26
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $11.24 / $16.64 / $51.00	Professional	26	$11.24	$16.64	$51.00
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $23.04 / $27.42 / $48.43	Professional	52	$23.04	$27.42	$48.43
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $38.86 / $48.17 / $100.21	Professional	TC	$38.86	$48.17	$100.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.22 / $62.50 / $137.40	Professional		$17.22	$62.50	$137.40
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $53.05 / $67.53 / $107.04	Professional		$53.05	$67.53	$107.04
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.46 / $15.01 / $24.55	Professional	26	$11.46	$15.01	$24.55
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.04 / $52.60 / $85.05	Professional	TC	$41.04	$52.60	$85.05
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $11.19 / $11.65 / $11.65	Facility	26	$11.19	$11.65	$11.65
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $46.57 / $51.78 / $56.23	Professional		$46.57	$51.78	$56.23
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.19 / $11.65 / $12.04	Professional	26	$11.19	$11.65	$12.04
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $35.40 / $40.13 / $44.20	Professional	TC	$35.40	$40.13	$44.20
United Facility/Professional Professional Modifier Low / Median / High Price $45.99 / $57.64 / $100.83	Professional		$45.99	$57.64	$100.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.57 / $13.30 / $23.30	Professional	26	$10.57	$13.30	$23.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.69 / $43.96 / $77.03	Professional	TC	$34.69	$43.96	$77.03