Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $16.60 / $39.81	Facility	26	$9.55	$16.60	$39.81
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.81 / $208.93 / $758.58	Facility	TC	$39.81	$208.93	$758.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $57.54 / $199.53	Professional		$15.49	$57.54	$199.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $22.91 / $64.57	Professional	26	$10.23	$22.91	$64.57
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $123.03 / $302.00	Professional	50	$45.71	$123.03	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $47.86 / $120.23	Professional	TC	$28.84	$47.86	$120.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $40.74 / $69.18	Professional		$31.62	$40.74	$69.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $12.88 / $20.89	Professional	26	$8.51	$12.88	$20.89
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $57.54 / $102.33	Professional	50	$47.86	$57.54	$102.33
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $41.69 / $63.10	Professional	TC	$29.51	$41.69	$63.10
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $120.23 / $169.82 / $245.47	Facility	TC	$120.23	$169.82	$245.47
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $50.12 / $77.62	Professional		$45.71	$50.12	$77.62
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.13 / $24.55	Professional	26	$10.96	$14.13	$24.55
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $91.20 / $100.00 / $158.49	Professional	50	$91.20	$100.00	$158.49
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $36.31 / $58.88	Professional	TC	$34.67	$36.31	$58.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.69 / $12.59 / $17.78	Facility	26	$2.69	$12.59	$17.78
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $8.51 / $39.81 / $56.23	Facility	TC	$8.51	$39.81	$56.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $51.29 / $91.20	Professional		$33.88	$51.29	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.49 / $22.39	Professional	26	$8.71	$13.49	$22.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $37.15 / $67.61	Professional	TC	$23.99	$37.15	$67.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $85.11	Professional		$52.48	$67.61	$85.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $14.79 / $18.20	Professional	26	$11.22	$14.79	$18.20
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $52.48 / $66.07	Professional	TC	$41.69	$52.48	$66.07
Geisinger Facility/Professional Facility Modifier TC Low / Median / High Price $37.15 / $37.15 / $37.15	Facility	TC	$37.15	$37.15	$37.15
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $51.29 / $100.00	Professional		$26.92	$51.29	$100.00
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $13.18 / $23.99	Professional	26	$8.91	$13.18	$23.99
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $38.90 / $77.62	Professional	TC	$18.20	$38.90	$77.62
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $165.96 / $288.40 / $512.86	Facility	TC	$165.96	$288.40	$512.86
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $53.70 / $67.61	Professional		$52.48	$53.70	$67.61
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $13.49 / $23.99	Professional	26	$11.48	$13.49	$23.99
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $25.70 / $112.20 / $131.83	Professional	50	$25.70	$112.20	$131.83
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $52.48 / $63.10	Professional	TC	$43.65	$52.48	$63.10
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $57.54 / $74.13	Professional		$54.95	$57.54	$74.13
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $13.49 / $20.42	Professional	26	$12.59	$13.49	$20.42
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $16.22 / $39.81	Facility	26	$9.55	$16.22	$39.81
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $39.81 / $194.98 / $758.58	Facility	TC	$39.81	$194.98	$758.58
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $57.54 / $141.25	Professional		$26.30	$57.54	$141.25
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $16.60 / $47.86	Professional	26	$9.77	$16.60	$47.86
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $45.71 / $123.03 / $288.40	Professional	50	$45.71	$123.03	$288.40
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $44.67 / $91.20	Professional	TC	$28.84	$44.67	$91.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $46.77 / $95.50	Professional		$18.62	$46.77	$95.50
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $19.95 / $19.95	Facility	26	$10.96	$19.95	$19.95
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $28.18 / $28.18 / $33.88	Facility	TC	$28.18	$28.18	$33.88
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $26.30 / $58.88	Professional		$8.71	$26.30	$58.88
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $11.22 / $19.95	Professional	26	$10.96	$11.22	$19.95
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.88 / $37.15	Professional	TC	$28.18	$33.88	$37.15
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $75.86	Professional		$32.36	$44.67	$75.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.02 / $20.42	Professional	26	$8.91	$12.02	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.11 / $57.54	Professional	TC	$23.44	$33.11	$57.54