Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $25.12 / $50.12	Facility	26	$12.59	$25.12	$50.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.81 / $138.04 / $501.19	Facility	TC	$39.81	$138.04	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $70.79 / $194.98	Professional		$43.65	$70.79	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $20.42 / $45.71	Professional	26	$12.02	$20.42	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $29.51 / $29.51 / $269.15	Professional	50	$29.51	$29.51	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $47.86 / $141.25	Professional	TC	$30.20	$47.86	$141.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $63.10	Professional		$34.67	$46.77	$63.10
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $14.45 / $22.91	Professional	26	$11.48	$14.45	$22.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $35.48 / $40.74	Professional	TC	$30.90	$35.48	$40.74
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $144.54 / $204.17 / $295.12	Facility	TC	$144.54	$204.17	$295.12
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $60.26 / $91.20	Professional		$52.48	$60.26	$91.20
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $18.20 / $28.18	Professional	26	$14.13	$18.20	$28.18
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $41.69 / $66.07	Professional	TC	$38.02	$41.69	$66.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.47 / $15.85 / $22.91	Facility	26	$3.47	$15.85	$22.91
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $9.33 / $43.65 / $61.66	Facility	TC	$9.33	$43.65	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $60.26 / $102.33	Professional		$39.81	$60.26	$102.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $18.20 / $29.51	Professional	26	$10.72	$18.20	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $43.65 / $75.86	Professional	TC	$28.84	$43.65	$75.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $74.13 / $93.33	Professional		$57.54	$74.13	$93.33
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $18.62 / $22.91	Professional	26	$14.45	$18.62	$22.91
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $54.95 / $69.18	Professional	TC	$43.65	$54.95	$69.18
Geisinger Facility/Professional Facility Modifier TC Low / Median / High Price $50.12 / $50.12 / $50.12	Facility	TC	$50.12	$50.12	$50.12
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $56.23 / $112.20	Professional		$37.15	$56.23	$112.20
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $16.22 / $30.20	Professional	26	$12.02	$16.22	$30.20
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $41.69 / $81.28	Professional	TC	$25.12	$41.69	$81.28
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $204.17 / $380.19 / $645.65	Facility	TC	$204.17	$380.19	$645.65
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $64.57 / $69.18	Professional		$58.88	$64.57	$69.18
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $16.98 / $22.91	Professional	26	$15.49	$16.98	$22.91
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $58.88 / $58.88 / $58.88	Professional	50	$58.88	$58.88	$58.88
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $48.98 / $69.18	Professional	TC	$48.98	$48.98	$69.18
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $20.89 / $50.12	Facility	26	$12.59	$20.89	$50.12
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $40.74 / $128.82 / $501.19	Facility	TC	$40.74	$128.82	$501.19
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $67.61 / $141.25	Professional		$43.65	$67.61	$141.25
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $18.62 / $38.90	Professional	26	$12.02	$18.62	$38.90
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $29.51 / $75.86 / $269.15	Professional	50	$29.51	$75.86	$269.15
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $47.86 / $93.33	Professional	TC	$30.90	$47.86	$93.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $60.26 / $549.54	Professional		$26.30	$60.26	$549.54
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $13.80 / $16.60	Facility	26	$13.80	$13.80	$16.60
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $34.67 / $34.67 / $38.02	Facility	TC	$34.67	$34.67	$38.02
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $51.29 / $131.83	Professional		$25.70	$51.29	$131.83
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $13.80 / $16.60	Professional	26	$13.49	$13.80	$16.60
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $37.15 / $41.69	Professional	TC	$34.67	$37.15	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $52.48 / $89.13	Professional		$41.69	$52.48	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.85 / $26.92	Professional	26	$12.02	$15.85	$26.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $37.15 / $66.07	Professional	TC	$28.84	$37.15	$66.07