Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $204.17 / $630.96	Facility		$69.18	$204.17	$630.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $14.13 / $34.67	Facility	26	$8.13	$14.13	$34.67
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $35.48 / $144.54 / $549.54	Facility	TC	$35.48	$144.54	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $48.98 / $165.96	Professional		$11.48	$48.98	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $16.60 / $53.70	Professional	26	$8.51	$16.60	$53.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.11 / $95.50 / $251.19	Professional	50	$33.11	$95.50	$251.19
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $67.61 / $67.61 / $67.61	Professional	52	$67.61	$67.61	$67.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $44.67 / $123.03	Professional	TC	$25.12	$44.67	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $31.62 / $54.95	Professional		$25.70	$31.62	$54.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.00 / $15.85	Professional	26	$6.92	$10.00	$15.85
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $39.81 / $43.65 / $75.86	Professional	50	$39.81	$43.65	$75.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.18 / $46.77	Professional	TC	$21.88	$28.18	$46.77
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,511.38 / $77,624.71	Facility		$5,011.87	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $104.71 / $147.91 / $213.80	Facility	TC	$104.71	$147.91	$213.80
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $44.67 / $69.18	Professional		$38.90	$44.67	$69.18
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $11.75 / $21.88	Professional	26	$9.12	$11.75	$21.88
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $89.13 / $138.04	Professional	50	$77.62	$89.13	$138.04
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $33.11 / $52.48	Professional	TC	$30.20	$33.11	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $85.11 / $208.93	Facility		$40.74	$85.11	$208.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $7.41 / $34.67 / $48.98	Facility	TC	$7.41	$34.67	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $44.67 / $79.43	Professional		$29.51	$44.67	$79.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.22 / $18.62	Professional	26	$7.08	$11.22	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.11 / $60.26	Professional	TC	$21.38	$33.11	$60.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $57.54 / $72.44	Professional		$44.67	$57.54	$72.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.59 / $15.49	Professional	26	$9.55	$12.59	$15.49
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $45.71 / $57.54	Professional	TC	$35.48	$45.71	$57.54
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 / $44.67 / $87.10	Professional		$23.99	$44.67	$87.10
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.96 / $19.95	Professional	26	$7.41	$10.96	$19.95
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $33.88 / $67.61	Professional	TC	$16.98	$33.88	$67.61
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $181.97 / $302.00	Facility		$83.18	$181.97	$302.00
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $123.03 / $263.03 / $426.58	Facility	TC	$123.03	$263.03	$426.58
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $48.98 / $57.54	Professional		$44.67	$48.98	$57.54
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $10.96 / $19.05	Professional	26	$9.55	$10.96	$19.05
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $21.38 / $26.92 / $102.33	Professional	50	$21.38	$26.92	$102.33
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $45.71 / $57.54	Professional	TC	$38.02	$45.71	$57.54
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $741.31 / $954.99	Facility		$741.31	$741.31	$954.99
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $66.07 / $151.36	Professional		$64.57	$66.07	$151.36
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $131.83 / $131.83	Professional	26	$16.98	$131.83	$131.83
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $204.17 / $588.84	Facility		$63.10	$204.17	$588.84
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $13.80 / $33.11	Facility	26	$8.13	$13.80	$33.11
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $35.48 / $131.83 / $549.54	Facility	TC	$35.48	$131.83	$549.54
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $48.98 / $123.03	Professional		$12.88	$48.98	$123.03
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $13.49 / $41.69	Professional	26	$8.13	$13.49	$41.69
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $25.70 / $100.00 / $234.42	Professional	50	$25.70	$100.00	$234.42
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $67.61 / $67.61 / $67.61	Professional	52	$67.61	$67.61	$67.61
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $39.81 / $83.18	Professional	TC	$25.12	$39.81	$83.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $42.66 / $81.28	Professional		$15.85	$42.66	$81.28
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $30.20 / $77.62	Facility		$15.85	$30.20	$77.62
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $8.91 / $17.38	Facility	26	$8.91	$8.91	$17.38
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $26.30 / $26.30 / $30.20	Facility	TC	$26.30	$26.30	$30.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $23.99 / $69.18	Professional		$15.85	$23.99	$69.18
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.12 / $17.38	Professional	26	$8.71	$9.12	$17.38
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $30.20 / $33.11	Professional	TC	$26.30	$30.20	$33.11
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 $28.18 / $38.90 / $66.07	Professional		$28.18	$38.90	$66.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $9.77 / $16.98	Professional	26	$7.59	$9.77	$16.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $30.20 / $51.29	Professional	TC	$21.38	$30.20	$51.29