Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $37.15 / $64.57	Facility	26	$26.30	$37.15	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $58.88 / $257.04	Professional		$36.31	$58.88	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $30.90 / $75.86	Professional	26	$23.44	$30.90	$75.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $33.11 / $309.03 / $323.59	Professional	52	$33.11	$309.03	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.99 / $114.82	Professional	TC	$15.85	$23.99	$114.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $34.67 / $40.74	Professional		$30.20	$34.67	$40.74
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $29.51 / $41.69	Professional	26	$25.12	$29.51	$41.69
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $10.72 / $10.72 / $10.72	Professional	TC	$10.72	$10.72	$10.72
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $44.67 / $100.00	Professional		$43.65	$44.67	$100.00
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $29.51 / $56.23	Professional	26	$28.18	$29.51	$56.23
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $15.49 / $44.67	Professional	TC	$14.79	$15.49	$44.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $30.90 / $43.65	Facility	26	$6.61	$30.90	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Professional		$38.90	$38.90	$38.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $25.12 / $25.12	Professional	26	$25.12	$25.12	$25.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $14.13 / $14.13	Professional	TC	$14.13	$14.13	$14.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $56.23 / $79.43	Professional		$47.86	$56.23	$79.43
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.02 / $54.95	Professional	26	$32.36	$38.02	$54.95
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $17.38 / $25.70	Professional	TC	$15.14	$17.38	$25.70
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $54.95 / $93.33	Professional		$40.74	$54.95	$93.33
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $32.36 / $60.26	Professional	26	$26.92	$32.36	$60.26
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $22.39 / $33.11	Professional	TC	$12.88	$22.39	$33.11
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $38.90 / $38.90	Facility	26	$38.90	$38.90	$38.90
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $52.48 / $60.26	Professional		$47.86	$52.48	$60.26
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $31.62 / $39.81	Professional	26	$30.20	$31.62	$39.81
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $21.88 / $21.88	Professional	TC	$21.88	$21.88	$21.88
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $102.33 / $102.33	Professional	26	$45.71	$102.33	$102.33
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $37.15 / $64.57	Facility	26	$26.30	$37.15	$64.57
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $60.26 / $144.54	Professional		$40.74	$60.26	$144.54
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $32.36 / $69.18	Professional	26	$23.44	$32.36	$69.18
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $33.11 / $309.03 / $323.59	Professional	52	$33.11	$309.03	$323.59
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $25.70 / $58.88	Professional	TC	$16.22	$25.70	$58.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $60.26 / $75.86	Professional		$12.88	$60.26	$75.86
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $33.11 / $33.11	Facility	26	$28.84	$33.11	$33.11
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $38.90 / $79.43	Professional		$15.14	$38.90	$79.43
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $28.84 / $33.11	Professional	26	$27.54	$28.84	$33.11
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $23.44 / $26.30	Professional	TC	$22.39	$23.44	$26.30
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $93.33	Professional		$42.66	$58.88	$93.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.88 / $52.48	Professional	26	$24.55	$33.88	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.92 / $42.66	Professional	TC	$17.78	$26.92	$42.66