Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $204.17 / $436.52	Facility		$44.67	$204.17	$436.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $13.80 / $27.54	Facility	26	$6.92	$13.80	$27.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $112.20 / $446.68	Facility	TC	$21.88	$112.20	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $32.36 / $109.65	Professional		$10.47	$32.36	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $13.49 / $38.90	Professional	26	$7.08	$13.49	$38.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.11 / $102.33 / $251.19	Professional	50	$33.11	$102.33	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $29.51 / $97.72	Professional	TC	$16.98	$29.51	$97.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $21.88 / $38.90	Professional		$17.38	$21.88	$38.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.13 / $12.88	Professional	26	$6.17	$8.13	$12.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $17.38 / $31.62	Professional	TC	$14.13	$17.38	$31.62
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $5,011.87 / $77,624.71	Facility		$100.00	$5,011.87	$77,624.71
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $81.28 / $114.82 / $162.18	Facility	TC	$81.28	$114.82	$162.18
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.88 / $61.66	Professional		$28.18	$33.88	$61.66
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.00 / $18.62	Professional	26	$7.76	$10.00	$18.62
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $56.23 / $67.61 / $123.03	Professional	50	$56.23	$67.61	$123.03
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $23.44 / $40.74	Professional	TC	$20.89	$23.44	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $58.88 / $208.93	Facility		$27.54	$58.88	$208.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.86 / $8.71 / $12.59	Facility	26	$1.86	$8.71	$12.59
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $5.01 / $23.44 / $33.88	Facility	TC	$5.01	$23.44	$33.88
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 $6.03 / $9.55 / $15.85	Professional	26	$6.03	$9.55	$15.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $24.55 / $40.74	Professional	TC	$15.85	$24.55	$40.74
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $39.81 / $50.12	Professional		$30.90	$39.81	$50.12
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.23 / $12.59	Professional	26	$7.76	$10.23	$12.59
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $29.51 / $37.15	Professional	TC	$22.91	$29.51	$37.15
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 $21.38 / $32.36 / $60.26	Professional		$21.38	$32.36	$60.26
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $9.12 / $16.60	Professional	26	$6.46	$9.12	$16.60
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $23.44 / $43.65	Professional	TC	$14.45	$23.44	$43.65
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $165.96 / $338.84	Facility		$91.20	$165.96	$338.84
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $123.03 / $213.80 / $524.81	Facility	TC	$123.03	$213.80	$524.81
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $34.67 / $38.02	Professional		$32.36	$34.67	$38.02
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.33 / $14.13	Professional	26	$7.94	$9.33	$14.13
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $66.07 / $66.07 / $66.07	Professional	50	$66.07	$66.07	$66.07
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $30.90 / $37.15	Professional	TC	$26.30	$30.90	$37.15
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 $39.81 / $199.53 / $436.52	Facility		$39.81	$199.53	$436.52
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $11.48 / $27.54	Facility	26	$6.92	$11.48	$27.54
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $97.72 / $446.68	Facility	TC	$21.88	$97.72	$446.68
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $35.48 / $81.28	Professional		$16.60	$35.48	$81.28
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $11.22 / $28.18	Professional	26	$6.92	$11.22	$28.18
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $33.11 / $102.33 / $251.19	Professional	50	$33.11	$102.33	$251.19
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $26.92 / $51.29	Professional	TC	$17.38	$26.92	$51.29
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $263.03 / $389.05	Facility		$208.93	$263.03	$389.05
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $38.02 / $56.23	Professional		$16.98	$38.02	$56.23
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $19.50 / $29.51	Facility		$16.60	$19.50	$29.51
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $8.51 / $8.51	Facility	26	$7.59	$8.51	$8.51
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $19.95 / $19.95 / $20.42	Facility	TC	$19.95	$19.95	$20.42
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $19.50 / $37.15	Professional		$12.30	$19.50	$37.15
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $7.94 / $8.51	Professional	26	$7.41	$7.94	$8.51
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $19.95 / $22.39	Professional	TC	$19.95	$19.95	$22.39
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 $22.91 / $29.51 / $50.12	Professional		$22.91	$29.51	$50.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $8.71 / $15.14	Professional	26	$6.17	$8.71	$15.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $20.42 / $35.48	Professional	TC	$15.85	$20.42	$35.48