Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $190.55 / $398.11	Facility		$79.43	$190.55	$398.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $81.28 / $138.04	Facility	26	$28.84	$81.28	$138.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $162.18 / $257.04 / $776.25	Facility	TC	$162.18	$257.04	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $134.90 / $501.19	Professional		$70.79	$134.90	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $72.44 / $309.03	Professional	26	$26.92	$72.44	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $70.79 / $316.23	Professional	TC	$45.71	$70.79	$316.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $91.20 / $102.33	Professional		$51.29	$91.20	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $31.62 / $61.66	Professional	26	$15.85	$31.62	$61.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $35.48 / $70.79	Professional	TC	$35.48	$35.48	$70.79
Capital Blue Cross Facility/Professional Facility Modifier TC Low / Median / High Price $181.97 / $338.84 / $363.08	Facility	TC	$181.97	$338.84	$363.08
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $128.82 / $173.78	Professional		$109.65	$128.82	$173.78
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $45.71 / $104.71	Professional	26	$33.88	$45.71	$104.71
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $77.62 / $117.49	Professional	TC	$50.12	$77.62	$117.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $177.83	Facility		$128.82	$128.82	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $50.12 / $70.79	Facility	26	$10.72	$50.12	$70.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $18.20 / $85.11 / $123.03	Facility	TC	$18.20	$85.11	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $64.57 / $144.54	Professional		$44.67	$64.57	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $25.70 / $60.26	Professional	26	$16.60	$25.70	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $38.02 / $87.10	Professional	TC	$25.12	$38.02	$87.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $154.88 / $199.53	Professional		$83.18	$154.88	$199.53
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $46.77 / $61.66	Professional	26	$24.55	$46.77	$61.66
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $107.15 / $141.25	Professional	TC	$58.88	$107.15	$141.25
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $123.03 / $208.93	Professional		$83.18	$123.03	$208.93
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $47.86 / $85.11	Professional	26	$36.31	$47.86	$85.11
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $83.18 / $125.89	Professional	TC	$34.67	$83.18	$125.89
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $831.76	Facility		$446.68	$446.68	$831.76
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $371.54 / $512.86 / $831.76	Facility	TC	$371.54	$512.86	$831.76
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $117.49 / $147.91	Professional		$36.31	$117.49	$147.91
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $36.31 / $54.95	Professional	26	$34.67	$36.31	$54.95
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $74.13 / $81.28	Professional	TC	$43.65	$74.13	$81.28
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $35.48 / $44.67	Professional	26	$30.20	$35.48	$44.67
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $190.55 / $398.11	Facility		$79.43	$190.55	$398.11
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $81.28 / $138.04	Facility	26	$28.84	$81.28	$138.04
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $107.15 / $257.04 / $776.25	Facility	TC	$107.15	$257.04	$776.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $120.23 / $354.81	Professional		$70.79	$120.23	$354.81
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $53.70 / $213.80	Professional	26	$26.92	$53.70	$213.80
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $72.44 / $186.21	Professional	TC	$48.98	$72.44	$186.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $165.96 / $213.80	Professional		$109.65	$165.96	$213.80
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $70.79 / $147.91	Professional		$17.78	$70.79	$147.91
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $33.88 / $48.98	Professional	26	$33.11	$33.88	$48.98
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $60.26 / $69.18	Professional	TC	$48.98	$60.26	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $102.33 / $158.49	Professional		$53.70	$102.33	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $36.31 / $58.88	Professional	26	$20.42	$36.31	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $66.07 / $107.15	Professional	TC	$36.31	$66.07	$107.15