Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $181.97 / $416.87	Facility		$66.07	$181.97	$416.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $18.62 / $35.48	Facility	26	$9.33	$18.62	$35.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $120.23 / $323.59	Facility	TC	$25.70	$120.23	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $44.67 / $151.36	Professional		$26.92	$44.67	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $13.80 / $43.65	Professional	26	$9.12	$13.80	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $31.62 / $83.18	Professional	TC	$18.20	$31.62	$83.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $26.30 / $38.02	Professional		$21.38	$26.30	$38.02
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.77 / $15.85	Professional	26	$7.94	$9.77	$15.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $20.42 / $33.11	Professional	TC	$15.49	$20.42	$33.11
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,511.38 / $77,624.71	Facility		$5,011.87	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $87.10 / $123.03 / $173.78	Facility	TC	$87.10	$123.03	$173.78
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $38.02 / $56.23	Professional		$32.36	$38.02	$56.23
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $13.49 / $20.89	Professional	26	$10.47	$13.49	$20.89
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $26.92 / $38.90	Professional	TC	$22.39	$26.92	$38.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $64.57 / $223.87	Facility		$32.36	$64.57	$223.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.51 / $11.75 / $16.98	Facility	26	$2.51	$11.75	$16.98
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.37 / $25.12 / $36.31	Facility	TC	$5.37	$25.12	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $38.02 / $64.57	Professional		$24.55	$38.02	$64.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $13.18 / $21.38	Professional	26	$7.76	$13.18	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.70 / $43.65	Professional	TC	$16.98	$25.70	$43.65
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $44.67 / $56.23	Professional		$34.67	$44.67	$56.23
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $13.18 / $16.22	Professional	26	$10.23	$13.18	$16.22
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $31.62 / $39.81	Professional	TC	$25.12	$31.62	$39.81
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $34.67 / $67.61	Professional		$23.44	$34.67	$67.61
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $11.75 / $21.88	Professional	26	$8.71	$11.75	$21.88
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $23.44 / $46.77	Professional	TC	$14.79	$23.44	$46.77
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $186.21 / $331.13	Facility		$58.88	$186.21	$331.13
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $123.03 / $239.88 / $389.05	Facility	TC	$123.03	$239.88	$389.05
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $38.90 / $46.77	Professional		$34.67	$38.90	$46.77
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.30 / $18.20	Professional	26	$10.96	$12.30	$18.20
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $28.18 / $40.74	Professional	TC	$25.70	$28.18	$40.74
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $2,511.89 / $4,265.80	Facility		$47.86	$2,511.89	$4,265.80
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Professional		$48.98	$48.98	$48.98
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $12.88 / $17.38	Professional	26	$11.48	$12.88	$17.38
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $181.97 / $416.87	Facility		$61.66	$181.97	$416.87
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $15.49 / $38.02	Facility	26	$9.33	$15.49	$38.02
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $114.82 / $323.59	Facility	TC	$25.70	$114.82	$323.59
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $41.69 / $97.72	Professional		$27.54	$41.69	$97.72
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.18 / $32.36	Professional	26	$8.91	$13.18	$32.36
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $27.54 / $57.54	Professional	TC	$18.20	$27.54	$57.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $43.65 / $63.10	Professional		$11.22	$43.65	$63.10
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $19.05 / $23.99 / $69.18	Facility		$19.05	$23.99	$69.18
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $10.23 / $10.23 / $12.02	Facility	26	$10.23	$10.23	$12.02
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $20.42 / $21.88 / $21.88	Facility	TC	$20.42	$21.88	$21.88
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $23.99 / $34.67	Professional		$12.02	$23.99	$34.67
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $10.23 / $12.02	Professional	26	$10.00	$10.23	$12.02
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $21.88 / $24.55	Professional	TC	$20.42	$21.88	$24.55
United Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $234.42 / $309.03	Facility		$131.83	$234.42	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $33.11 / $56.23	Professional		$25.70	$33.11	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $11.48 / $19.50	Professional	26	$8.71	$11.48	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $21.88 / $38.90	Professional	TC	$16.98	$21.88	$38.90