Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $223.87 / $398.11	Facility		$60.26	$223.87	$398.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $17.38 / $37.15	Facility	26	$8.71	$17.38	$37.15
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.55 / $97.72 / $446.68	Facility	TC	$24.55	$97.72	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $45.71 / $154.88	Professional		$28.18	$45.71	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.14 / $38.90	Professional	26	$8.91	$15.14	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $30.20 / $69.18	Professional	TC	$18.20	$30.20	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $24.55 / $39.81	Professional		$20.89	$24.55	$39.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.23 / $15.85	Professional	26	$7.76	$10.23	$15.85
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $22.91 / $34.67	Professional	TC	$15.49	$22.91	$34.67
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $8,511.38 / $77,624.71	Facility		$21.88	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $97.72 / $138.04 / $194.98	Facility	TC	$97.72	$138.04	$194.98
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $40.74 / $81.28	Professional		$31.62	$40.74	$81.28
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.18 / $24.55	Professional	26	$9.77	$13.18	$24.55
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $28.18 / $52.48	Professional	TC	$22.39	$28.18	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $64.57 / $257.04	Facility		$29.51	$64.57	$257.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.34 / $10.96 / $15.85	Facility	26	$2.34	$10.96	$15.85
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 $26.30 / $40.74 / $67.61	Professional		$26.30	$40.74	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.18 / $21.38	Professional	26	$7.94	$13.18	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $28.18 / $46.77	Professional	TC	$17.78	$28.18	$46.77
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 $9.77 / $12.88 / $15.85	Professional	26	$9.77	$12.88	$15.85
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $32.36 / $40.74	Professional	TC	$25.12	$32.36	$40.74
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $38.02	Facility		$38.02	$38.02	$38.02
Geisinger Facility/Professional Facility Modifier TC Low / Median / High Price $38.02 / $38.02 / $38.02	Facility	TC	$38.02	$38.02	$38.02
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $38.02 / $69.18	Professional		$27.54	$38.02	$69.18
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.30 / $21.38	Professional	26	$8.91	$12.30	$21.38
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.92 / $47.86	Professional	TC	$17.78	$26.92	$47.86
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $218.78 / $363.08	Facility		$107.15	$218.78	$363.08
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $147.91 / $316.23 / $575.44	Facility	TC	$147.91	$316.23	$575.44
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $38.90 / $41.69	Professional		$36.31	$38.90	$41.69
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $11.75 / $16.60	Professional	26	$10.00	$11.75	$16.60
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.11 / $40.74	Professional	TC	$28.18	$33.11	$40.74
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $107.15 / $229.09	Facility		$75.86	$107.15	$229.09
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $218.78 / $398.11	Facility		$50.12	$218.78	$398.11
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $17.38 / $37.15	Facility	26	$8.91	$17.38	$37.15
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $93.33 / $457.09	Facility	TC	$25.70	$93.33	$457.09
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $44.67 / $97.72	Professional		$28.18	$44.67	$97.72
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.80 / $32.36	Professional	26	$8.71	$13.80	$32.36
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $29.51 / $58.88	Professional	TC	$19.05	$29.51	$58.88
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $169.82 / $234.42	Facility		$162.18	$169.82	$234.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $45.71 / $66.07	Professional		$10.72	$45.71	$66.07
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $24.55 / $70.79	Facility		$16.22	$24.55	$70.79
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $12.02 / $12.02	Facility	26	$9.55	$12.02	$12.02
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $25.12 / $25.12	Facility	TC	$21.88	$25.12	$25.12
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $24.55 / $69.18	Professional		$15.85	$24.55	$69.18
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $9.77 / $12.02	Professional	26	$9.55	$9.77	$12.02
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $22.39 / $25.12	Professional	TC	$21.88	$22.39	$25.12
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $281.84 / $371.54	Facility		$158.49	$281.84	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $34.67 / $56.23	Professional		$26.92	$34.67	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.96 / $18.62	Professional	26	$8.32	$10.96	$18.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $23.44 / $38.90	Professional	TC	$18.20	$23.44	$38.90