Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $158.49 / $263.03	Facility		$67.61	$158.49	$263.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $93.33 / $109.65	Facility	26	$22.91	$93.33	$109.65
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $56.23 / $154.88 / $426.58	Facility	TC	$56.23	$154.88	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $75.86 / $213.80	Professional		$44.67	$75.86	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $50.12 / $218.78	Professional	26	$19.95	$50.12	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.02 / $158.49	Professional	TC	$26.92	$38.02	$158.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $38.02 / $43.65	Professional	26	$13.18	$38.02	$43.65
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $37.15 / $37.15	Professional	TC	$37.15	$37.15	$37.15
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $144.54 / $263.03 / $281.84	Facility	TC	$144.54	$263.03	$281.84
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $69.18 / $120.23	Professional		$66.07	$69.18	$120.23
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $27.54 / $52.48	Professional	26	$26.92	$27.54	$52.48
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $40.74 / $67.61	Professional	TC	$38.90	$40.74	$67.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $173.78	Facility		$67.61	$67.61	$173.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $97.72	Facility	26	$14.45	$67.61	$97.72
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $11.48 / $53.70 / $75.86	Facility	TC	$11.48	$53.70	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $60.26 / $134.90	Professional		$31.62	$60.26	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $28.84 / $69.18	Professional	26	$12.88	$28.84	$69.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $28.18 / $63.10	Professional	TC	$18.62	$28.18	$63.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $91.20 / $120.23	Professional		$50.12	$91.20	$120.23
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $37.15 / $48.98	Professional	26	$19.50	$37.15	$48.98
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $53.70 / $70.79	Professional	TC	$30.20	$53.70	$70.79
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $109.65 / $199.53	Professional		$74.13	$109.65	$199.53
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $56.23 / $107.15	Professional	26	$30.20	$56.23	$107.15
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $54.95 / $102.33	Professional	TC	$40.74	$54.95	$102.33
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Facility		$269.15	$269.15	$269.15
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $158.49 / $158.49 / $190.55	Facility	TC	$158.49	$158.49	$190.55
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $74.13 / $144.54	Professional		$64.57	$74.13	$144.54
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $30.20 / $50.12	Professional	26	$27.54	$30.20	$50.12
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $154.88 / $263.03	Facility		$93.33	$154.88	$263.03
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $64.57 / $109.65	Facility	26	$38.02	$64.57	$109.65
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $56.23 / $154.88 / $426.58	Facility	TC	$56.23	$154.88	$426.58
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $79.43 / $194.98	Professional		$50.12	$79.43	$194.98
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $40.74 / $190.55	Professional	26	$20.89	$40.74	$190.55
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $45.71 / $114.82	Professional	TC	$28.84	$45.71	$114.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $114.82 / $125.89	Professional		$95.50	$114.82	$125.89
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $56.23 / $131.83	Professional		$25.70	$56.23	$131.83
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $26.30 / $67.61	Professional	26	$25.70	$26.30	$67.61
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $38.02 / $52.48	Professional	TC	$37.15	$38.02	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $67.61 / $125.89	Professional		$38.90	$67.61	$125.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $28.84 / $52.48	Professional	26	$16.22	$28.84	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $37.15 / $63.10	Professional	TC	$22.39	$37.15	$63.10