Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.90 / $157.97 / $412.37	Facility		$35.90	$157.97	$412.37
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.65 / $11.93 / $21.43	Facility	26	$9.65	$11.93	$21.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.36 / $34.28 / $125.96	Professional		$22.36	$34.28	$125.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.23 / $11.17 / $33.27	Professional	26	$9.23	$11.17	$33.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $24.21 / $50.26	Professional	TC	$19.76	$24.21	$50.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.95 / $27.37 / $28.72	Professional		$23.95	$27.37	$28.72
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.14 / $9.84 / $16.73	Professional	26	$8.14	$9.84	$16.73
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $571.69 / $571.69 / $571.69	Facility		$571.69	$571.69	$571.69
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $127.98 / $8,639.91 / $79,506.39	Facility		$127.98	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $35.51 / $51.88 / $72.91	Professional		$35.51	$51.88	$72.91
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $17.38 / $24.81	Professional	26	$10.72	$17.38	$24.81
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $24.79 / $34.47 / $48.11	Professional	TC	$24.79	$34.47	$48.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $32.29 / $71.48 / $215.83	Facility		$32.29	$71.48	$215.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.95 / $11.95 / $11.95	Facility	26	$11.95	$11.95	$11.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.37 / $41.07 / $67.14	Professional		$27.37	$41.07	$67.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.20 / $21.36	Professional	26	$8.13	$13.20	$21.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.73 / $28.06 / $46.84	Professional	TC	$17.73	$28.06	$46.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $37.40 / $47.44 / $57.14	Professional		$37.40	$47.44	$57.14
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.76 / $14.15 / $22.26	Professional	26	$11.76	$14.15	$22.26
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.71 / $36.90 / $52.51	Professional	TC	$29.71	$36.90	$52.51
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.22 / $174.37 / $298.54	Facility		$85.22	$174.37	$298.54
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $42.00 / $46.67	Professional		$35.97	$42.00	$46.67
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.38 / $12.28 / $16.96	Professional	26	$11.38	$12.28	$16.96
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.92 / $31.92 / $37.72	Professional	TC	$31.92	$31.92	$37.72
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $571.69 / $571.69 / $724.28	Facility		$571.69	$571.69	$724.28
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $37.17 / $136.52 / $332.32	Facility		$37.17	$136.52	$332.32
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $9.65 / $13.54 / $31.27	Facility	26	$9.65	$13.54	$31.27
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $22.36 / $37.17 / $100.44	Professional		$22.36	$37.17	$100.44
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $9.57 / $14.00 / $31.27	Professional	26	$9.57	$14.00	$31.27
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $21.28 / $27.39 / $57.00	Professional	TC	$21.28	$27.39	$57.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $132.59 / $137.00 / $190.59	Facility		$132.59	$137.00	$190.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.43 / $37.25 / $66.76	Professional		$11.43	$37.25	$66.76
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $31.38 / $70.26 / $260.37	Facility		$31.38	$70.26	$260.37
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $7.17 / $11.95 / $11.95	Facility	26	$7.17	$11.95	$11.95
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $27.64 / $40.84 / $67.14	Professional		$27.64	$40.84	$67.14
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $13.12 / $21.42	Professional	26	$8.23	$13.12	$21.42
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.06 / $45.44	Professional	TC	$19.05	$28.06	$45.44
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $34.00 / $35.58 / $35.58	Facility		$34.00	$35.58	$35.58
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $10.61 / $10.61 / $12.00	Facility	26	$10.61	$10.61	$12.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $35.58 / $38.51	Professional		$34.00	$35.58	$38.51
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $10.61 / $12.00	Professional	26	$10.35	$10.61	$12.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.00 / $24.97 / $27.49	Professional	TC	$22.00	$24.97	$27.49
United Facility/Professional Professional Modifier Low / Median / High Price $29.46 / $37.76 / $63.34	Professional		$29.46	$37.76	$63.34
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $12.71 / $21.54	Professional	26	$10.11	$12.71	$21.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.80 / $25.73 / $45.41	Professional	TC	$19.80	$25.73	$45.41