Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $208.93 / $478.63	Facility		$56.23	$208.93	$478.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $14.79 / $28.84	Facility	26	$7.59	$14.79	$28.84
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.92 / $141.25 / $467.74	Facility	TC	$26.92	$141.25	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $36.31 / $125.89	Professional		$10.72	$36.31	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $14.13 / $42.66	Professional	26	$7.76	$14.13	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $32.36 / $112.20 / $213.80	Professional	50	$32.36	$112.20	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $38.02 / $95.50	Professional	TC	$19.95	$38.02	$95.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $26.92 / $48.98	Professional		$19.95	$26.92	$48.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.55 / $14.13	Professional	26	$6.61	$9.55	$14.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $40.74 / $40.74 / $40.74	Professional	50	$40.74	$40.74	$40.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $22.39 / $35.48	Professional	TC	$17.38	$22.39	$35.48
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $8,511.38 / $77,624.71	Facility		$24.55	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $109.65 / $154.88 / $218.78	Facility	TC	$109.65	$154.88	$218.78
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $36.31 / $67.61	Professional		$31.62	$36.31	$67.61
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 50 Low / Median / High Price $63.10 / $72.44 / $138.04	Professional	50	$63.10	$72.44	$138.04
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $26.92 / $47.86	Professional	TC	$23.44	$26.92	$47.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $66.07 / $208.93	Facility		$30.90	$66.07	$208.93
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 $5.62 / $26.30 / $38.02	Facility	TC	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $38.90 / $66.07	Professional		$25.12	$38.90	$66.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.47 / $16.98	Professional	26	$6.61	$10.47	$16.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.84 / $48.98	Professional	TC	$18.20	$28.84	$48.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $44.67 / $56.23	Professional		$35.48	$44.67	$56.23
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 $26.92 / $33.88 / $42.66	Professional	TC	$26.92	$33.88	$42.66
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $33.88 / $33.88	Facility		$33.88	$33.88	$33.88
Geisinger Facility/Professional Facility Modifier TC Low / Median / High Price $33.88 / $33.88 / $33.88	Facility	TC	$33.88	$33.88	$33.88
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $37.15 / $69.18	Professional		$23.99	$37.15	$69.18
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 $16.98 / $27.54 / $51.29	Professional	TC	$16.98	$27.54	$51.29
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $177.83 / $288.40	Facility		$97.72	$177.83	$288.40
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $128.82 / $223.87 / $407.38	Facility	TC	$128.82	$223.87	$407.38
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $38.90 / $45.71	Professional		$36.31	$38.90	$45.71
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $10.23 / $16.98	Professional	26	$8.71	$10.23	$16.98
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $83.18 / $95.50	Professional	50	$72.44	$83.18	$95.50
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $30.20 / $43.65	Professional	TC	$25.12	$30.20	$43.65
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $89.13 / $190.55	Facility		$63.10	$89.13	$190.55
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $204.17 / $467.74	Facility		$48.98	$204.17	$467.74
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $12.59 / $28.84	Facility	26	$7.59	$12.59	$28.84
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $26.92 / $109.65 / $489.78	Facility	TC	$26.92	$109.65	$489.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $39.81 / $93.33	Professional		$12.88	$39.81	$93.33
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $12.02 / $30.90	Professional	26	$7.41	$12.02	$30.90
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $128.82 / $239.88	Professional	50	$30.20	$128.82	$239.88
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $32.36 / $63.10	Professional	TC	$19.95	$32.36	$63.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $912.01 / $933.25 / $1,148.15	Facility		$912.01	$933.25	$1,148.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $40.74 / $67.61	Professional		$14.13	$40.74	$67.61
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $19.95 / $33.88	Facility		$16.98	$19.95	$33.88
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $9.55 / $9.55	Facility	26	$8.32	$9.55	$9.55
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $23.99 / $23.99	Facility	TC	$22.91	$23.99	$23.99
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $19.95 / $35.48	Professional		$16.98	$19.95	$35.48
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $8.51 / $9.55	Professional	26	$8.13	$8.51	$9.55
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $23.44 / $25.12	Professional	TC	$22.39	$23.44	$25.12
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 / $53.70	Professional		$25.70	$33.11	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $9.12 / $15.85	Professional	26	$6.76	$9.12	$15.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $23.99 / $39.81	Professional	TC	$19.05	$23.99	$39.81