Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $295.12 / $676.08	Facility		$93.33	$295.12	$676.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $54.95 / $72.44	Facility	26	$38.90	$54.95	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $93.33 / $398.11	Professional		$40.74	$93.33	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $53.70 / $158.49	Professional	26	$31.62	$53.70	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $37.15 / $169.82	Professional	TC	$25.12	$37.15	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $30.20 / $75.86	Professional		$28.84	$30.20	$75.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $42.66 / $60.26	Professional	26	$39.81	$42.66	$60.26
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $16.60 / $16.60	Professional	TC	$16.60	$16.60	$16.60
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,258.93 / $57,543.99	Facility		$1,174.90	$1,258.93	$57,543.99
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $69.18 / $109.65	Professional		$66.07	$69.18	$109.65
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $47.86 / $77.62	Professional	26	$38.90	$47.86	$77.62
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.88 / $93.33	Professional	TC	$28.18	$33.88	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $43.65 / $63.10	Facility	26	$9.33	$43.65	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $194.98 / $331.13	Professional		$63.10	$194.98	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $79.43 / $131.83	Professional	26	$36.31	$79.43	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $117.49 / $208.93	Professional	TC	$27.54	$117.49	$208.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $102.33 / $138.04	Professional		$69.18	$102.33	$138.04
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $56.23 / $75.86	Professional	26	$38.02	$56.23	$75.86
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $46.77 / $60.26	Professional	TC	$31.62	$46.77	$60.26
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $95.50 / $257.04	Professional		$66.07	$95.50	$257.04
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $54.95 / $107.15	Professional	26	$37.15	$54.95	$107.15
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $41.69 / $173.78	Professional	TC	$28.18	$41.69	$173.78
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $199.53 / $257.04	Facility		$162.18	$199.53	$257.04
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $269.15 / $645.65	Facility		$93.33	$269.15	$645.65
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $54.95 / $72.44	Facility	26	$38.90	$54.95	$72.44
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $114.82 / $380.19	Professional		$56.23	$114.82	$380.19
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $66.07 / $154.88	Professional	26	$36.31	$66.07	$154.88
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $51.29 / $194.98	Professional	TC	$26.92	$51.29	$194.98
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $234.42	Facility		$131.83	$131.83	$234.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $251.19 / $389.05	Professional		$117.49	$251.19	$389.05
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $26.30 / $79.43 / $407.38	Facility		$26.30	$79.43	$407.38
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $36.31 / $83.18	Facility	26	$36.31	$36.31	$83.18
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $51.29 / $107.15	Professional		$26.30	$51.29	$107.15
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $36.31 / $37.15	Professional	26	$34.67	$36.31	$37.15
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $25.70 / $28.84	Professional	TC	$25.12	$25.70	$28.84
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $512.86 / $3,890.45	Facility		$162.18	$512.86	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $93.33 / $275.42	Professional		$64.57	$93.33	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $53.70 / $102.33	Professional	26	$35.48	$53.70	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $38.90 / $173.78	Professional	TC	$27.54	$38.90	$173.78