Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $398.11 / $1,230.27	Facility		$79.43	$398.11	$1,230.27
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $57.54 / $109.65	Facility	26	$28.84	$57.54	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $97.72 / $398.11	Professional		$50.12	$97.72	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $46.77 / $125.89	Professional	26	$26.92	$46.77	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $38.02 / $208.93	Professional	TC	$20.89	$38.02	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $48.98 / $72.44	Professional		$42.66	$48.98	$72.44
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $29.51 / $46.77	Professional	26	$21.38	$29.51	$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 Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $41.69 / $77.62	Professional	26	$36.31	$41.69	$77.62
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $37.15 / $229.09	Professional	TC	$33.11	$37.15	$229.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $309.03 / $309.03	Facility		$93.33	$309.03	$309.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $34.67 / $48.98	Facility	26	$7.41	$34.67	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $107.15 / $245.47	Professional		$48.98	$107.15	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $38.90 / $61.66	Professional	26	$24.55	$38.90	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $51.29 / $194.98	Professional	TC	$22.91	$51.29	$194.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $89.13 / $107.15	Professional		$75.86	$89.13	$107.15
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $41.69 / $51.29	Professional	26	$26.92	$41.69	$51.29
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $44.67 / $56.23	Professional	TC	$28.84	$44.67	$56.23
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $870.96	Facility		$91.20	$91.20	$870.96
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $100.00 / $190.55	Professional		$66.07	$100.00	$190.55
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $40.74 / $64.57	Professional	26	$27.54	$40.74	$64.57
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $52.48 / $144.54	Professional	TC	$33.11	$52.48	$144.54
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $354.81 / $794.33	Facility		$125.89	$354.81	$794.33
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $794.33 / $794.33 / $794.33	Facility	26	$794.33	$794.33	$794.33
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $70.79 / $75.86	Professional		$64.57	$70.79	$75.86
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $36.31 / $51.29	Professional	26	$32.36	$36.31	$51.29
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $380.19 / $1,202.26	Facility		$70.79	$380.19	$1,202.26
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $53.70 / $109.65	Facility	26	$28.84	$53.70	$109.65
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $93.33 / $295.12	Professional		$51.29	$93.33	$295.12
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $42.66 / $100.00	Professional	26	$26.92	$42.66	$100.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $41.69 / $186.21	Professional	TC	$22.91	$41.69	$186.21
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $11,481.54 / $16,218.10	Facility		$562.34	$11,481.54	$16,218.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $120.23 / $426.58	Professional		$112.20	$120.23	$426.58
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $7.08 / $56.23 / $75.86	Facility		$7.08	$56.23	$75.86
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $30.20 / $41.69	Facility	26	$30.20	$30.20	$41.69
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $7.08 / $38.02 / $69.18	Professional		$7.08	$38.02	$69.18
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $30.20 / $30.90	Professional	26	$28.84	$30.20	$30.90
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $26.30 / $29.51	Professional	TC	$26.30	$26.30	$29.51
United Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $75.86 / $208.93	Professional		$51.29	$75.86	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $33.88 / $56.23	Professional	26	$25.70	$33.88	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.90 / $165.96	Professional	TC	$22.39	$30.90	$165.96