Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.36 / $94.24 / $657.85	Facility		$59.36	$94.24	$657.85
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.29 / $13.14 / $42.22	Facility	26	$3.29	$13.14	$42.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.69 / $36.29 / $66.81	Professional		$30.69	$36.29	$66.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.17 / $15.47 / $59.61	Professional	26	$12.17	$15.47	$59.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $22.27 / $38.46	Professional	TC	$17.89	$22.27	$38.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.77 / $28.85 / $31.66	Professional		$27.77	$28.85	$31.66
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.18 / $13.86 / $22.14	Professional	26	$10.18	$13.86	$22.14
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $3,314.72 / $6,813.95 / $8,910.54	Facility		$3,314.72	$6,813.95	$8,910.54
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $15.03 / $17.36 / $28.50	Professional	26	$15.03	$17.36	$28.50
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $127.98 / $8,639.91 / $79,506.39	Facility		$127.98	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $37.29 / $54.85 / $62.16	Professional		$37.29	$54.85	$62.16
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $13.46 / $22.81 / $36.15	Professional	26	$13.46	$22.81	$36.15
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $23.84 / $28.40 / $39.36	Professional	TC	$23.84	$28.40	$39.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.87 / $42.87 / $57.43	Facility		$42.87	$42.87	$57.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.88 / $15.88 / $15.88	Facility	26	$15.88	$15.88	$15.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.64 / $44.53 / $72.48	Professional		$29.64	$44.53	$72.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $18.62 / $29.14	Professional	26	$10.80	$18.62	$29.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.46 / $26.63 / $43.73	Professional	TC	$17.46	$26.63	$43.73
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $39.78 / $53.01 / $91.56	Professional		$39.78	$53.01	$91.56
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.21 / $19.47 / $30.53	Professional	26	$15.21	$19.47	$30.53
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.87 / $38.40 / $61.03	Professional	TC	$29.87	$38.40	$61.03
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $98.00 / $119.70 / $536.04	Facility		$98.00	$119.70	$536.04
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.43 / $39.92 / $42.23	Professional		$14.43	$39.92	$42.23
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.72 / $16.39 / $22.64	Professional	26	$14.72	$16.39	$22.64
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $3,314.72 / $5,210.05 / $8,910.54	Facility		$3,314.72	$5,210.05	$8,910.54
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $13.42 / $17.36 / $28.50	Professional	26	$13.42	$17.36	$28.50
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $53.13 / $101.23 / $775.29	Facility		$53.13	$101.23	$775.29
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.10 / $20.89 / $42.97	Facility	26	$12.10	$20.89	$42.97
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $42.45 / $84.31	Professional		$30.91	$42.45	$84.31
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $12.80 / $18.86 / $44.22	Professional	26	$12.80	$18.86	$44.22
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $20.28 / $27.78 / $54.88	Professional	TC	$20.28	$27.78	$54.88
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,994.89 / $7,043.55 / $12,140.25	Facility		$4,994.89	$7,043.55	$12,140.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.62 / $41.70 / $75.52	Professional		$14.62	$41.70	$75.52
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $42.87 / $42.87 / $57.43	Facility		$42.87	$42.87	$57.43
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.88 / $15.88 / $15.88	Facility	26	$15.88	$15.88	$15.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $30.44 / $44.53 / $72.31	Professional		$30.44	$44.53	$72.31
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.37 / $18.54 / $29.75	Professional	26	$11.37	$18.54	$29.75
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $17.55 / $26.99 / $42.98	Professional	TC	$17.55	$26.99	$42.98
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $37.35 / $37.95 / $37.95	Facility		$37.35	$37.95	$37.95
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $13.92 / $13.92 / $16.44	Facility	26	$13.92	$13.92	$16.44
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $37.34 / $37.95 / $40.90	Professional		$37.34	$37.95	$40.90
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.42 / $14.08 / $16.44	Professional	26	$13.42	$14.08	$16.44
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $20.91 / $24.03 / $26.45	Professional	TC	$20.91	$24.03	$26.45
United Facility/Professional Professional Modifier Low / Median / High Price $28.46 / $37.29 / $65.55	Professional		$28.46	$37.29	$65.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.38 / $16.02 / $27.01	Professional	26	$12.38	$16.02	$27.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.77 / $23.89 / $39.27	Professional	TC	$16.77	$23.89	$39.27