Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.34 / $167.40 / $438.78	Facility		$80.34	$167.40	$438.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.87 / $50.60 / $138.40	Facility	26	$28.87	$50.60	$138.40
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $146.72 / $295.92 / $591.84	Facility	TC	$146.72	$295.92	$591.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.13 / $106.01 / $341.04	Professional		$77.13	$106.01	$341.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.19 / $44.57 / $176.10	Professional	26	$26.19	$44.57	$176.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.82 / $64.50 / $147.66	Professional	TC	$47.82	$64.50	$147.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.35 / $89.86 / $164.32	Professional		$51.35	$89.86	$164.32
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.97 / $47.73 / $63.88	Professional	26	$15.97	$47.73	$63.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.38 / $35.38 / $70.76	Professional	TC	$35.38	$35.38	$70.76
AmeriHealth Facility/Professional Professional Modifier 26 Low / Median / High Price $33.78 / $36.67 / $61.80	Professional	26	$33.78	$36.67	$61.80
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $182.43 / $253.91 / $359.00	Facility	TC	$182.43	$253.91	$359.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $108.86 / $130.65 / $191.96	Professional		$108.86	$130.65	$191.96
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $33.86 / $48.43 / $104.74	Professional	26	$33.86	$48.43	$104.74
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $50.03 / $77.84 / $125.57	Professional	TC	$50.03	$77.84	$125.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $118.22 / $118.22 / $176.16	Facility		$118.22	$118.22	$176.16
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.22 / $71.22 / $71.22	Facility	26	$71.22	$71.22	$71.22
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $104.94 / $104.94 / $104.94	Facility	TC	$104.94	$104.94	$104.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.36 / $63.42 / $143.62	Professional		$43.36	$63.42	$143.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.18 / $22.91 / $54.64	Professional	26	$16.18	$22.91	$54.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.06 / $37.47 / $84.92	Professional	TC	$22.06	$37.47	$84.92
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $70.98 / $164.04 / $216.67	Professional		$70.98	$164.04	$216.67
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.72 / $48.55 / $120.57	Professional	26	$20.72	$48.55	$120.57
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.27 / $117.14 / $155.21	Professional	TC	$50.27	$117.14	$155.21
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $404.42 / $445.81 / $821.66	Facility		$404.42	$445.81	$821.66
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $382.98 / $511.99 / $825.85	Facility	TC	$382.98	$511.99	$825.85
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.22 / $142.69 / $154.41	Professional		$94.22	$142.69	$154.41
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.58 / $42.85 / $56.68	Professional	26	$35.58	$42.85	$56.68
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.04 / $44.45 / $78.05	Professional	TC	$31.04	$44.45	$78.05
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $33.78 / $36.67 / $61.80	Professional	26	$33.78	$36.67	$61.80
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $83.03 / $212.67 / $438.78	Facility		$83.03	$212.67	$438.78
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $28.87 / $50.60 / $138.40	Facility	26	$28.87	$50.60	$138.40
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $106.84 / $257.22 / $591.84	Facility	TC	$106.84	$257.22	$591.84
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $79.06 / $111.75 / $276.52	Professional		$79.06	$111.75	$276.52
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $27.50 / $46.58 / $138.40	Professional	26	$27.50	$46.58	$138.40
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $51.57 / $69.28 / $142.62	Professional	TC	$51.57	$69.28	$142.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.47 / $102.49 / $186.11	Professional		$33.47	$102.49	$186.11
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $118.22 / $118.22 / $176.16	Facility		$118.22	$118.22	$176.16
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $71.22 / $71.22 / $71.22	Facility	26	$71.22	$71.22	$71.22
Priority Health Facility/Professional Facility Modifier TC Low / Median / High Price $104.94 / $104.94 / $104.94	Facility	TC	$104.94	$104.94	$104.94
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $45.11 / $69.18 / $144.66	Professional		$45.11	$69.18	$144.66
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.14 / $31.50 / $56.00	Professional	26	$16.14	$31.50	$56.00
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.50 / $40.21 / $95.53	Professional	TC	$23.50	$40.21	$95.53
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $82.32 / $95.79 / $103.33	Professional		$82.32	$95.79	$103.33
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $33.35 / $34.18 / $48.50	Professional	26	$33.35	$34.18	$48.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $36.60 / $61.93 / $68.56	Professional	TC	$36.60	$61.93	$68.56
United Facility/Professional Professional Modifier Low / Median / High Price $55.55 / $102.04 / $181.27	Professional		$55.55	$102.04	$181.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.54 / $36.09 / $58.45	Professional	26	$20.54	$36.09	$58.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.27 / $65.95 / $106.41	Professional	TC	$36.27	$65.95	$106.41