Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $223.87 / $489.78	Facility		$85.11	$223.87	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $57.54 / $112.20	Facility	26	$28.84	$57.54	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $102.33 / $426.58	Professional		$48.98	$102.33	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $56.23 / $151.36	Professional	26	$28.84	$56.23	$151.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $67.61 / $181.97 / $660.69	Professional	50	$67.61	$181.97	$660.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $61.66 / $269.15	Professional	TC	$42.66	$61.66	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $67.61 / $85.11	Professional		$63.10	$67.61	$85.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $38.90 / $60.26	Professional	26	$25.70	$38.90	$60.26
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $85.11 / $100.00 / $117.49	Professional	50	$85.11	$100.00	$117.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $43.65 / $114.82	Professional	TC	$37.15	$43.65	$114.82
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 Professional Modifier Low / Median / High Price $91.20 / $104.71 / $158.49	Professional		$91.20	$104.71	$158.49
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $40.74 / $64.57	Professional	26	$35.48	$40.74	$64.57
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $134.90 / $158.49 / $239.88	Professional	50	$134.90	$158.49	$239.88
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $63.10 / $95.50	Professional	TC	$54.95	$63.10	$95.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $141.25 / $223.87	Facility		$64.57	$141.25	$223.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $52.48	Facility	26	$7.94	$37.15	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $107.15 / $165.96	Professional		$67.61	$107.15	$165.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $40.74 / $64.57	Professional	26	$25.70	$40.74	$64.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $64.57 / $100.00	Professional	TC	$41.69	$64.57	$100.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $141.25	Professional		$100.00	$117.49	$141.25
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $42.66 / $51.29	Professional	26	$26.92	$42.66	$51.29
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $72.44 / $89.13	Professional	TC	$45.71	$72.44	$89.13
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $102.33 / $162.18	Professional		$75.86	$102.33	$162.18
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $40.74 / $61.66	Professional	26	$30.90	$40.74	$61.66
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $63.10 / $100.00	Professional	TC	$40.74	$63.10	$100.00
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $194.98 / $346.74	Facility		$69.18	$194.98	$346.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $95.50 / $112.20	Professional		$91.20	$95.50	$112.20
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.90 / $56.23	Professional	26	$36.31	$38.90	$56.23
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $56.23 / $144.54 / $165.96	Professional	50	$56.23	$144.54	$165.96
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $67.61 / $93.33	Professional	TC	$67.61	$67.61	$93.33
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $1,380.38 / $2,398.83	Facility		$95.50	$1,380.38	$2,398.83
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $33.88 / $54.95	Professional	26	$33.88	$33.88	$54.95
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $223.87 / $501.19	Facility		$87.10	$223.87	$501.19
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $48.98 / $112.20	Facility	26	$28.84	$48.98	$112.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $104.71 / $257.04	Professional		$66.07	$104.71	$257.04
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $47.86 / $102.33	Professional	26	$28.84	$47.86	$102.33
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $66.07 / $186.21 / $660.69	Professional	50	$66.07	$186.21	$660.69
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $64.57 / $131.83	Professional	TC	$44.67	$64.57	$131.83
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $338.84 / $457.09	Facility		$323.59	$338.84	$457.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $63.10 / $158.49	Professional		$47.86	$63.10	$158.49
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $53.70 / $93.33	Facility		$34.67	$53.70	$93.33
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $38.02 / $38.02	Facility	26	$32.36	$38.02	$38.02
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $77.62 / $117.49	Professional		$34.67	$77.62	$117.49
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $33.11 / $38.02	Professional	26	$31.62	$33.11	$38.02
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $51.29 / $56.23	Professional	TC	$48.98	$51.29	$56.23
United Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $245.47 / $309.03	Facility		$131.83	$245.47	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $91.20 / $144.54	Professional		$69.18	$91.20	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $36.31 / $56.23	Professional	26	$26.92	$36.31	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $56.23 / $91.20	Professional	TC	$41.69	$56.23	$91.20