Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.18 / $124.30 / $330.15	Facility		$66.18	$124.30	$330.15
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.09 / $17.51 / $47.91	Facility	26	$10.09	$17.51	$47.91
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $95.53 / $296.44 / $856.00	Facility	TC	$95.53	$296.44	$856.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.11 / $79.23 / $299.00	Professional		$59.11	$79.23	$299.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.60 / $29.67 / $118.69	Professional	26	$9.60	$29.67	$118.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.70 / $64.70 / $99.76	Professional	TC	$39.70	$64.70	$99.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $48.72 / $73.19	Professional		$37.15	$48.72	$73.19
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $16.59 / $21.57	Professional	26	$5.53	$16.59	$21.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $31.64 / $31.64 / $31.64	Professional	TC	$31.64	$31.64	$31.64
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $83.64 / $84.48 / $108.03	Professional		$83.64	$84.48	$108.03
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $11.74 / $12.25 / $15.67	Professional	26	$11.74	$12.25	$15.67
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $191.48 / $266.50 / $376.81	Facility	TC	$191.48	$266.50	$376.81
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $72.16 / $81.76 / $135.82	Professional		$72.16	$81.76	$135.82
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $11.72 / $16.77 / $29.55	Professional	26	$11.72	$16.77	$29.55
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $69.59 / $115.84	Professional	TC	$48.98	$69.59	$115.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $116.59 / $116.59 / $132.22	Facility		$116.59	$116.59	$132.22
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.26 / $20.26 / $20.26	Facility	26	$20.26	$20.26	$20.26
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $111.96 / $111.96 / $111.96	Facility	TC	$111.96	$111.96	$111.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.79 / $42.07 / $97.98	Professional		$28.79	$42.07	$97.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $7.29 / $17.45	Professional	26	$5.53	$7.29	$17.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.12 / $35.95 / $79.94	Professional	TC	$23.12	$35.95	$79.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.16 / $120.95 / $160.38	Professional		$52.16	$120.95	$160.38
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.21 / $16.22 / $21.58	Professional	26	$7.21	$16.22	$21.58
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.95 / $104.73 / $138.80	Professional	TC	$44.95	$104.73	$138.80
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $323.45 / $323.45 / $632.57	Facility		$323.45	$323.45	$632.57
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.61 / $89.57 / $113.28	Professional		$61.61	$89.57	$113.28
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.20 / $13.96 / $19.30	Professional	26	$12.20	$13.96	$19.30
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.65 / $40.65 / $76.98	Professional	TC	$40.65	$40.65	$76.98
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $83.64 / $84.48 / $108.03	Professional		$83.64	$84.48	$108.03
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $11.74 / $12.25 / $15.67	Professional	26	$11.74	$12.25	$15.67
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $36.00 / $117.28 / $320.77	Facility		$36.00	$117.28	$320.77
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $10.09 / $17.51 / $47.91	Facility	26	$10.09	$17.51	$47.91
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $95.53 / $296.44 / $716.00	Facility	TC	$95.53	$296.44	$716.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $63.03 / $84.67 / $220.00	Professional		$63.03	$84.67	$220.00
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $24.75 / $99.60	Professional	26	$9.61	$24.75	$99.60
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $53.42 / $71.42 / $132.57	Professional	TC	$53.42	$71.42	$132.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $15.46 / $82.11 / $136.53	Professional		$15.46	$82.11	$136.53
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $116.59 / $116.59 / $132.22	Facility		$116.59	$116.59	$132.22
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $20.26 / $20.26 / $20.26	Facility	26	$20.26	$20.26	$20.26
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $111.96 / $111.96 / $111.96	Facility	TC	$111.96	$111.96	$111.96
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $29.36 / $51.83 / $100.34	Professional		$29.36	$51.83	$100.34
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.53 / $10.55 / $17.78	Professional	26	$5.53	$10.55	$17.78
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.12 / $37.84 / $83.74	Professional	TC	$24.12	$37.84	$83.74
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $60.35 / $77.04 / $84.78	Professional		$60.35	$77.04	$84.78
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.58 / $11.83 / $13.50	Professional	26	$11.58	$11.83	$13.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $47.40 / $65.70 / $72.73	Professional	TC	$47.40	$65.70	$72.73
United Facility/Professional Professional Modifier Low / Median / High Price $40.09 / $72.93 / $109.40	Professional		$40.09	$72.93	$109.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $12.39 / $20.23	Professional	26	$6.81	$12.39	$20.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.29 / $60.54 / $99.06	Professional	TC	$33.29	$60.54	$99.06