Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.13 / $198.21 / $376.22	Facility		$37.13	$198.21	$376.22
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.20 / $9.02 / $16.80	Facility	26	$7.20	$9.02	$16.80
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.17 / $108.88 / $286.25	Facility	TC	$30.17	$108.88	$286.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.75 / $31.47 / $108.00	Professional		$15.75	$31.47	$108.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.94 / $10.81 / $36.42	Professional	26	$6.94	$10.81	$36.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.82 / $23.06 / $47.32	Professional	TC	$18.82	$23.06	$47.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $25.15 / $58.32	Professional		$20.89	$25.15	$58.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.98 / $8.55 / $13.27	Professional	26	$5.98	$8.55	$13.27
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.85 / $17.85 / $22.98	Professional	TC	$17.85	$17.85	$22.98
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $40.11 / $86.17 / $861.80	Facility		$40.11	$86.17	$861.80
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $10.96 / $160.88	Professional	26	$8.94	$10.96	$160.88
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $18.91 / $8,639.91 / $79,506.39	Facility		$18.91	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $87.92 / $117.41 / $156.51	Facility	TC	$87.92	$117.41	$156.51
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $45.64 / $68.26	Professional		$30.91	$45.64	$68.26
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $7.71 / $13.01 / $20.14	Professional	26	$7.71	$13.01	$20.14
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $23.20 / $32.36 / $48.11	Professional	TC	$23.20	$32.36	$48.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.75 / $66.80 / $215.83	Facility		$30.75	$66.80	$215.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.86 / $8.86 / $8.86	Facility	26	$8.86	$8.86	$8.86
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $27.22 / $27.22 / $27.22	Facility	TC	$27.22	$27.22	$27.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.14 / $36.94 / $58.77	Professional		$24.14	$36.94	$58.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.13 / $15.77	Professional	26	$6.03	$10.13	$15.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.36 / $26.66 / $43.98	Professional	TC	$17.36	$26.66	$43.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $34.03 / $41.50 / $50.13	Professional		$34.03	$41.50	$50.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.47 / $10.15 / $15.95	Professional	26	$8.47	$10.15	$15.95
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.80 / $34.54 / $49.15	Professional	TC	$27.80	$34.54	$49.15
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.44 / $171.90 / $357.30	Facility		$93.44	$171.90	$357.30
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $121.89 / $281.75 / $526.87	Facility	TC	$121.89	$281.75	$526.87
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.32 / $38.78 / $45.48	Professional		$33.32	$38.78	$45.48
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.22 / $10.00 / $14.19	Professional	26	$8.22	$10.00	$14.19
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.50 / $29.50 / $34.86	Professional	TC	$29.50	$29.50	$34.86
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $61.14 / $87.45 / $189.09	Facility		$61.14	$87.45	$189.09
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $8.94 / $10.96 / $19.23	Professional	26	$8.94	$10.96	$19.23
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $39.67 / $189.70 / $376.34	Facility		$39.67	$189.70	$376.34
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $6.94 / $9.74 / $23.32	Facility	26	$6.94	$9.74	$23.32
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $25.71 / $95.96 / $305.02	Facility	TC	$25.71	$95.96	$305.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $15.75 / $33.18 / $81.95	Professional		$15.75	$33.18	$81.95
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.10 / $10.97 / $30.00	Professional	26	$7.10	$10.97	$30.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $26.00 / $53.02	Professional	TC	$19.64	$26.00	$53.02
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $431.71 / $446.61 / $1,042.19	Facility		$431.71	$446.61	$1,042.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $8.36 / $30.13 / $59.48	Professional		$8.36	$30.13	$59.48
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $28.97 / $64.86 / $260.37	Facility		$28.97	$64.86	$260.37
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $5.76 / $8.86 / $8.86	Facility	26	$5.76	$8.86	$8.86
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $15.49 / $27.22 / $27.22	Facility	TC	$15.49	$27.22	$27.22
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $24.79 / $36.51 / $58.77	Professional		$24.79	$36.51	$58.77
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.21 / $10.13 / $16.32	Professional	26	$6.21	$10.13	$16.32
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.07 / $26.59 / $42.25	Professional	TC	$18.07	$26.59	$42.25
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $31.01 / $31.01 / $31.50	Facility		$31.01	$31.01	$31.50
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $7.94 / $9.50	Facility	26	$7.94	$7.94	$9.50
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $22.00 / $23.07 / $23.07	Facility	TC	$22.00	$23.07	$23.07
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $30.56 / $31.01 / $33.67	Professional		$30.56	$31.01	$33.67
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $7.95 / $9.50	Professional	26	$7.74	$7.95	$9.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.00 / $23.07 / $25.40	Professional	TC	$22.00	$23.07	$25.40
United Facility/Professional Professional Modifier Low / Median / High Price $26.95 / $32.92 / $55.61	Professional		$26.95	$32.92	$55.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.53 / $9.34 / $15.68	Professional	26	$7.53	$9.34	$15.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $24.30 / $40.92	Professional	TC	$19.48	$24.30	$40.92