Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $194.98 / $323.59	Facility		$39.81	$194.98	$323.59
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $14.79 / $32.36	Facility	26	$7.59	$14.79	$32.36
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.95 / $77.62 / $316.23	Facility	TC	$19.95	$77.62	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $38.02 / $120.23	Professional		$23.44	$38.02	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.48 / $30.90	Professional	26	$7.76	$11.48	$30.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $25.12 / $67.61	Professional	TC	$15.14	$25.12	$67.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $21.88 / $33.88	Professional		$17.78	$21.88	$33.88
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.91 / $13.80	Professional	26	$6.46	$8.91	$13.80
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $19.95 / $29.51	Professional	TC	$15.49	$19.95	$29.51
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $16.22 / $5,011.87 / $77,624.71	Facility		$16.22	$5,011.87	$77,624.71
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $74.13 / $102.33 / $147.91	Facility	TC	$74.13	$102.33	$147.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $35.48 / $63.10	Professional		$26.92	$35.48	$63.10
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $10.96 / $19.95	Professional	26	$8.32	$10.96	$19.95
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $24.55 / $43.65	Professional	TC	$18.62	$24.55	$43.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $53.70 / $257.04	Facility		$25.12	$53.70	$257.04
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.04 / $9.55 / $13.49	Facility	26	$2.04	$9.55	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $4.57 / $21.38 / $30.20	Facility	TC	$4.57	$21.38	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $33.88 / $57.54	Professional		$22.39	$33.88	$57.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.47 / $17.38	Professional	26	$6.61	$10.47	$17.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $23.44 / $39.81	Professional	TC	$15.49	$23.44	$39.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $38.02 / $47.86	Professional		$29.51	$38.02	$47.86
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.22 / $13.80	Professional	26	$8.51	$11.22	$13.80
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $26.92 / $33.88	Professional	TC	$21.38	$26.92	$33.88
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $30.90 / $30.90	Facility		$30.90	$30.90	$30.90
Geisinger Facility/Professional Facility Modifier TC Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	TC	$30.90	$30.90	$30.90
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $32.36 / $58.88	Professional		$21.88	$32.36	$58.88
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.00 / $18.20	Professional	26	$7.08	$10.00	$18.20
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $22.39 / $40.74	Professional	TC	$14.13	$22.39	$40.74
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $213.80 / $380.19	Facility		$81.28	$213.80	$380.19
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $147.91 / $363.08 / $489.78	Facility	TC	$147.91	$363.08	$489.78
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $32.36 / $38.90	Professional		$30.90	$32.36	$38.90
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.23 / $14.79	Professional	26	$8.71	$10.23	$14.79
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $28.18 / $35.48	Professional	TC	$23.99	$28.18	$35.48
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $79.43 / $173.78	Facility		$56.23	$79.43	$173.78
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $194.98 / $323.59	Facility		$34.67	$194.98	$323.59
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $12.59 / $32.36	Facility	26	$7.59	$12.59	$32.36
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $75.86 / $316.23	Facility	TC	$21.88	$75.86	$316.23
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $37.15 / $81.28	Professional		$23.99	$37.15	$81.28
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.22 / $26.30	Professional	26	$7.08	$11.22	$26.30
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $25.12 / $50.12	Professional	TC	$15.85	$25.12	$50.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $38.90 / $58.88	Professional		$17.78	$38.90	$58.88
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $19.95 / $26.92	Facility		$16.98	$19.95	$26.92
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $8.32 / $9.55	Facility	26	$8.32	$8.32	$9.55
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $18.62 / $18.62 / $19.50	Facility	TC	$18.62	$18.62	$19.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $19.95 / $26.30	Professional		$16.60	$19.95	$26.30
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $8.32 / $9.55	Professional	26	$8.13	$8.32	$9.55
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $18.62 / $20.42	Professional	TC	$18.20	$18.62	$20.42
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 $21.88 / $28.84 / $48.98	Professional		$21.88	$28.84	$48.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $9.12 / $15.85	Professional	26	$6.92	$9.12	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $19.95 / $34.67	Professional	TC	$14.79	$19.95	$34.67