Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.78 / $19.62 / $19.62	Facility	26	$16.78	$19.62	$19.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.46 / $76.81 / $296.00	Professional		$63.46	$76.81	$296.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $24.14 / $74.00	Professional	26	$17.78	$24.14	$74.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.68 / $54.52 / $103.58	Professional	TC	$45.68	$54.52	$103.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $68.26 / $68.26 / $68.26	Professional		$68.26	$68.26	$68.26
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.19 / $20.45 / $34.36	Professional	26	$19.19	$20.45	$34.36
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $24.78 / $40.61	Professional	26	$17.82	$24.78	$40.61
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $73.13 / $115.45 / $134.62	Professional		$73.13	$115.45	$134.62
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $20.68 / $32.77 / $37.29	Professional	26	$20.68	$32.77	$37.29
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $52.44 / $82.75 / $97.54	Professional	TC	$52.44	$82.75	$97.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.32 / $23.32 / $23.32	Facility	26	$23.32	$23.32	$23.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $67.55	Professional		$67.55	$67.55	$67.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $18.45	Professional	26	$18.45	$18.45	$18.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $49.10	Professional	TC	$49.10	$49.10	$49.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $94.65 / $110.77 / $126.76	Professional		$94.65	$110.77	$126.76
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.38 / $30.90 / $33.86	Professional	26	$26.38	$30.90	$33.86
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $68.28 / $87.04 / $92.91	Professional	TC	$68.28	$87.04	$92.91
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.80 / $73.80 / $75.09	Professional		$73.80	$73.80	$75.09
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.60 / $22.77 / $33.58	Professional	26	$20.60	$22.77	$33.58
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $20.65 / $21.91 / $36.20	Professional	26	$20.65	$21.91	$36.20
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $19.62 / $19.62 / $19.62	Facility	26	$19.62	$19.62	$19.62
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $67.02 / $85.26 / $239.20	Professional		$67.02	$85.26	$239.20
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $18.07 / $27.50 / $58.27	Professional	26	$18.07	$27.50	$58.27
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $47.96 / $59.30 / $124.85	Professional	TC	$47.96	$59.30	$124.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.83 / $84.36 / $137.97	Professional		$30.83	$84.36	$137.97
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $23.32 / $23.32 / $23.32	Facility	26	$23.32	$23.32	$23.32
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $67.55	Professional		$67.55	$67.55	$67.55
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $18.45	Professional	26	$18.45	$18.45	$18.45
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $49.10	Professional	TC	$49.10	$49.10	$49.10
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $20.14 / $20.14 / $21.96	Facility	26	$20.14	$20.14	$21.96
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $70.23 / $71.36 / $77.89	Professional		$70.23	$71.36	$77.89
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.68 / $20.14 / $21.96	Professional	26	$19.68	$20.14	$21.96
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $51.21 / $56.38	Professional	TC	$50.12	$51.21	$56.38
United Facility/Professional Professional Modifier Low / Median / High Price $65.33 / $95.64 / $159.74	Professional		$65.33	$95.64	$159.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.46 / $24.14 / $38.29	Professional	26	$18.46	$24.14	$38.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.87 / $67.70 / $126.94	Professional	TC	$46.87	$67.70	$126.94