Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $12.02 / $18.20	Facility	26	$8.51	$12.02	$18.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $239.88	Professional		$52.48	$67.61	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.48 / $34.67	Professional	26	$7.94	$11.48	$34.67
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $8.13 / $8.32 / $39.81	Professional	52	$8.13	$8.32	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $52.48 / $112.20	Professional	TC	$42.66	$52.48	$112.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $54.95 / $83.18	Professional		$46.77	$54.95	$83.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.33 / $14.45	Professional	26	$7.76	$9.33	$14.45
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $46.77 / $75.86	Professional	TC	$46.77	$46.77	$75.86
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $56.23 / $93.33	Professional		$53.70	$56.23	$93.33
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.12 / $15.49	Professional	26	$8.71	$9.12	$15.49
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $46.77 / $79.43	Professional	TC	$44.67	$46.77	$79.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.14 / $10.00 / $14.13	Facility	26	$2.14	$10.00	$14.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $69.18 / $114.82	Professional		$52.48	$69.18	$114.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $10.72 / $17.78	Professional	26	$8.51	$10.72	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $57.54 / $97.72	Professional	TC	$44.67	$57.54	$97.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $89.13 / $128.82	Professional		$67.61	$89.13	$128.82
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.88 / $18.62	Professional	26	$9.55	$12.88	$18.62
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $77.62 / $112.20	Professional	TC	$57.54	$77.62	$112.20
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $63.10 / $104.71	Professional		$52.48	$63.10	$104.71
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $9.77 / $15.85	Professional	26	$8.13	$9.77	$15.85
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $53.70 / $89.13	Professional	TC	$43.65	$53.70	$89.13
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $63.10 / $83.18	Professional		$58.88	$63.10	$83.18
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $10.47 / $16.60	Professional	26	$9.77	$10.47	$16.60
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $52.48 / $53.70	Professional	TC	$50.12	$52.48	$53.70
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $9.12 / $12.02	Professional	26	$9.12	$9.12	$12.02
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $12.02 / $18.20	Facility	26	$8.51	$12.02	$18.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $147.91	Professional		$52.48	$72.44	$147.91
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $11.48 / $25.70	Professional	26	$7.94	$11.48	$25.70
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $8.13 / $8.32 / $39.81	Professional	52	$8.13	$8.32	$39.81
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $61.66 / $117.49	Professional	TC	$44.67	$61.66	$117.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $104.71 / $147.91	Professional		$63.10	$104.71	$147.91
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $8.71 / $8.71	Facility	26	$8.71	$8.71	$8.71
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $52.48 / $323.59	Professional		$15.49	$52.48	$323.59
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $8.71 / $8.91	Professional	26	$8.71	$8.71	$8.91
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $45.71 / $50.12	Professional	TC	$44.67	$45.71	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $60.26 / $102.33	Professional		$46.77	$60.26	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.77 / $16.60	Professional	26	$7.59	$9.77	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $50.12 / $85.11	Professional	TC	$38.90	$50.12	$85.11