Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.99 / $9.28 / $15.35	Facility	26	$8.99	$9.28	$15.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.32 / $60.81 / $126.21	Professional		$51.32	$60.81	$126.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.66 / $9.28 / $34.85	Professional	26	$7.66	$9.28	$34.85
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.84 / $27.45 / $31.94	Professional	52	$22.84	$27.45	$31.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.84 / $47.25 / $75.56	Professional	TC	$40.84	$47.25	$75.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.77 / $51.98 / $82.72	Professional		$45.77	$51.98	$82.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $10.30 / $14.39	Professional	26	$7.50	$10.30	$14.39
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $38.40 / $38.40 / $39.45	Professional	TC	$38.40	$38.40	$39.45
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $62.45 / $67.81 / $83.83	Professional		$62.45	$67.81	$83.83
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $15.92 / $15.92 / $15.92	Professional	26	$15.92	$15.92	$15.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $53.87 / $55.90 / $100.42	Professional		$53.87	$55.90	$100.42
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $9.06 / $16.69	Professional	26	$8.73	$9.06	$16.69
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $45.13 / $46.84 / $84.07	Professional	TC	$45.13	$46.84	$84.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.06 / $10.06 / $10.06	Facility	26	$10.06	$10.06	$10.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.06 / $68.84 / $112.32	Professional		$54.06	$68.84	$112.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $10.73 / $17.75	Professional	26	$8.66	$10.73	$17.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.73 / $57.89 / $95.99	Professional	TC	$44.73	$57.89	$95.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $60.25 / $79.91 / $112.17	Professional		$60.25	$79.91	$112.17
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.57 / $11.92 / $16.42	Professional	26	$9.57	$11.92	$16.42
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.68 / $68.59 / $94.44	Professional	TC	$50.68	$68.59	$94.44
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.64 / $66.92 / $83.11	Professional		$57.64	$66.92	$83.11
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.67 / $10.91 / $19.48	Professional	26	$9.67	$10.91	$19.48
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $34.78 / $34.78 / $34.78	Professional	52	$34.78	$34.78	$34.78
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.64 / $52.88 / $53.57	Professional	TC	$50.64	$52.88	$53.57
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $62.45 / $67.81 / $109.49	Professional		$62.45	$67.81	$109.49
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $9.08 / $9.08 / $15.92	Professional	26	$9.08	$9.08	$15.92
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $8.57 / $10.21 / $15.50	Facility	26	$8.57	$10.21	$15.50
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $52.67 / $66.65 / $141.79	Professional		$52.67	$66.65	$141.79
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $8.14 / $11.59 / $33.83	Professional	26	$8.14	$11.59	$33.83
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $24.05 / $28.17 / $50.48	Professional	52	$24.05	$28.17	$50.48
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $45.02 / $54.35 / $108.06	Professional	TC	$45.02	$54.35	$108.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.01 / $71.80 / $142.10	Professional		$12.01	$71.80	$142.10
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $10.06 / $10.06 / $10.06	Facility	26	$10.06	$10.06	$10.06
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $53.36 / $68.55 / $108.60	Professional		$53.36	$68.55	$108.60
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $10.62 / $17.75	Professional	26	$8.52	$10.62	$17.75
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.71 / $57.48 / $95.34	Professional	TC	$44.71	$57.48	$95.34
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $7.47 / $8.64 / $8.64	Facility	26	$7.47	$8.64	$8.64
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $45.98 / $53.85 / $58.71	Professional		$45.98	$53.85	$58.71
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $7.47 / $8.64 / $8.94	Professional	26	$7.47	$8.64	$8.94
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $38.50 / $45.20 / $49.77	Professional	TC	$38.50	$45.20	$49.77
United Facility/Professional Professional Modifier Low / Median / High Price $46.11 / $59.64 / $105.12	Professional		$46.11	$59.64	$105.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $9.78 / $17.03	Professional	26	$7.50	$9.78	$17.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.90 / $50.40 / $87.49	Professional	TC	$39.90	$50.40	$87.49