Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $131.83 / $831.76	Facility		$79.43	$131.83	$831.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $87.10 / $147.91	Facility	26	$30.90	$87.10	$147.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $131.83 / $380.19 / $954.99	Facility	TC	$131.83	$380.19	$954.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $158.49 / $794.33	Professional		$56.23	$158.49	$794.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $154.88 / $851.14	Professional	26	$33.88	$154.88	$851.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $85.11 / $602.56	Professional	TC	$25.70	$85.11	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $63.10 / $120.23	Professional		$33.11	$63.10	$120.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $51.29 / $67.61	Professional	26	$16.98	$51.29	$67.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $16.22 / $51.29	Professional	TC	$16.22	$16.22	$51.29
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $213.80 / $398.11 / $416.87	Facility	TC	$213.80	$398.11	$416.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $112.20 / $144.54	Professional		$74.13	$112.20	$144.54
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $48.98 / $93.33	Professional	26	$38.02	$48.98	$93.33
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $48.98 / $89.13	Professional	TC	$35.48	$48.98	$89.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $144.54	Facility		$57.54	$57.54	$144.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.75 / $54.95 / $77.62	Facility	26	$11.75	$54.95	$77.62
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $10.23 / $47.86 / $67.61	Facility	TC	$10.23	$47.86	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $61.66 / $125.89	Professional		$33.11	$61.66	$125.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $25.12 / $56.23	Professional	26	$16.98	$25.12	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $35.48 / $75.86	Professional	TC	$16.22	$35.48	$75.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $97.72 / $128.82	Professional		$52.48	$97.72	$128.82
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $50.12 / $66.07	Professional	26	$26.30	$50.12	$66.07
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $47.86 / $63.10	Professional	TC	$26.92	$47.86	$63.10
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $147.91	Professional		$72.44	$100.00	$147.91
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $46.77 / $81.28	Professional	26	$37.15	$46.77	$81.28
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $53.70 / $83.18	Professional	TC	$36.31	$53.70	$83.18
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $138.04 / $269.15	Facility		$134.90	$138.04	$269.15
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $125.89 / $158.49 / $257.04	Facility	TC	$125.89	$158.49	$257.04
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $77.62 / $100.00	Professional		$69.18	$77.62	$100.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $39.81 / $58.88	Professional	26	$36.31	$39.81	$58.88
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $47.86 / $61.66	Professional	TC	$36.31	$47.86	$61.66
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.02 / $47.86	Professional	26	$32.36	$38.02	$47.86
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $131.83 / $831.76	Facility		$79.43	$131.83	$831.76
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $87.10 / $147.91	Facility	26	$30.90	$87.10	$147.91
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $131.83 / $302.00 / $954.99	Facility	TC	$131.83	$302.00	$954.99
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $102.33 / $562.34	Professional		$56.23	$102.33	$562.34
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $89.13 / $794.33	Professional	26	$30.20	$89.13	$794.33
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $50.12 / $331.13	Professional	TC	$25.70	$50.12	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $125.89 / $134.90	Professional		$104.71	$125.89	$134.90
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $29.51 / $117.49	Professional		$9.77	$29.51	$117.49
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $35.48 / $48.98	Professional	26	$35.48	$35.48	$48.98
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $33.11 / $64.57	Professional	TC	$32.36	$33.11	$64.57
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $69.18 / $117.49	Professional		$41.69	$69.18	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $38.90 / $63.10	Professional	26	$21.38	$38.90	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $31.62 / $58.88	Professional	TC	$18.20	$31.62	$58.88