Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.23 / $210.34 / $353.54	Facility		$60.23	$210.34	$353.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.23 / $10.19 / $25.42	Facility	26	$8.23	$10.19	$25.42
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.28 / $144.94 / $347.46	Facility	TC	$24.28	$144.94	$347.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.69 / $33.20 / $112.00	Professional		$24.69	$33.20	$112.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.84 / $9.69 / $36.53	Professional	26	$7.84	$9.69	$36.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $20.16 / $50.65	Professional	TC	$16.60	$20.16	$50.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.26 / $23.65 / $54.82	Professional		$22.26	$23.65	$54.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $11.51 / $14.40	Professional	26	$6.61	$11.51	$14.40
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $15.65 / $22.55 / $31.67	Professional	TC	$15.65	$22.55	$31.67
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $44.12 / $94.74 / $1,106.32	Facility		$44.12	$94.74	$1,106.32
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $10.11 / $11.84 / $87.81	Professional	26	$10.11	$11.84	$87.81
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $63.60 / $8,639.91 / $79,506.39	Facility		$63.60	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $80.06 / $106.92 / $142.52	Facility	TC	$80.06	$106.92	$142.52
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $29.05 / $43.12 / $51.37	Professional		$29.05	$43.12	$51.37
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.12 / $17.80	Professional	26	$8.71	$14.12	$17.80
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $20.34 / $28.64 / $33.54	Professional	TC	$20.34	$28.64	$33.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.92 / $59.39 / $260.37	Facility		$33.92	$59.39	$260.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.75 / $34.27 / $54.78	Professional		$21.75	$34.27	$54.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.35 / $11.03 / $17.36	Professional	26	$6.35	$11.03	$17.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.46 / $23.07 / $37.70	Professional	TC	$15.46	$23.07	$37.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $29.97 / $38.84 / $46.86	Professional		$29.97	$38.84	$46.86
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.56 / $11.48 / $18.05	Professional	26	$9.56	$11.48	$18.05
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.39 / $30.28 / $43.08	Professional	TC	$24.39	$30.28	$43.08
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.91 / $180.03 / $330.10	Facility		$56.91	$180.03	$330.10
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $117.01 / $263.08 / $392.51	Facility	TC	$117.01	$263.08	$392.51
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.62 / $34.22 / $38.19	Professional		$30.62	$34.22	$38.19
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.34 / $10.38 / $15.53	Professional	26	$9.34	$10.38	$15.53
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $26.07 / $37.24	Professional	TC	$23.51	$26.07	$37.24
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $66.02 / $89.42 / $211.81	Facility		$66.02	$89.42	$211.81
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $8.73 / $11.34 / $87.81	Professional	26	$8.73	$11.34	$87.81
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $54.26 / $198.09 / $407.74	Facility		$54.26	$198.09	$407.74
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $7.84 / $11.01 / $27.05	Facility	26	$7.84	$11.01	$27.05
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $24.04 / $144.94 / $403.88	Facility	TC	$24.04	$144.94	$403.88
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $24.86 / $37.54 / $106.40	Professional		$24.86	$37.54	$106.40
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $8.02 / $10.21 / $33.90	Professional	26	$8.02	$10.21	$33.90
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $17.44 / $23.24 / $50.65	Professional	TC	$17.44	$23.24	$50.65
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $640.07 / $669.20 / $1,003.93	Facility		$640.07	$669.20	$1,003.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.25 / $28.52 / $48.86	Professional		$9.25	$28.52	$48.86
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $27.39 / $58.71 / $260.37	Facility		$27.39	$58.71	$260.37
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $10.01 / $10.01 / $10.01	Facility	26	$10.01	$10.01	$10.01
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $24.24 / $24.24 / $24.24	Facility	TC	$24.24	$24.24	$24.24
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $21.93 / $34.18 / $54.46	Professional		$21.93	$34.18	$54.46
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.53 / $11.10 / $17.36	Professional	26	$6.53	$11.10	$17.36
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.46 / $22.96 / $37.18	Professional	TC	$15.46	$22.96	$37.18
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $28.85 / $28.85 / $29.01	Facility		$28.85	$28.85	$29.01
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.61 / $8.61 / $10.07	Facility	26	$8.61	$8.61	$10.07
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $18.94 / $20.23 / $20.23	Facility	TC	$18.94	$20.23	$20.23
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $28.45 / $28.85 / $31.22	Professional		$28.45	$28.85	$31.22
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.40 / $8.61 / $10.07	Professional	26	$8.40	$8.61	$10.07
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $18.94 / $20.23 / $22.27	Professional	TC	$18.94	$20.23	$22.27
United Facility/Professional Professional Modifier Low / Median / High Price $24.88 / $30.97 / $54.24	Professional		$24.88	$30.97	$54.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.28 / $10.32 / $17.66	Professional	26	$8.28	$10.32	$17.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.05 / $21.78 / $35.86	Professional	TC	$17.05	$21.78	$35.86