Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $211.85 / $479.95	Facility		$95.00	$211.85	$479.95
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.14 / $19.14 / $28.69	Facility	26	$19.14	$19.14	$28.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.76 / $78.68 / $178.77	Professional		$42.76	$78.68	$178.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.75 / $33.02 / $113.34	Professional	26	$26.75	$33.02	$113.34
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $61.38 / $192.41 / $334.86	Professional	50	$61.38	$192.41	$334.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $19.55 / $24.15 / $48.65	Professional	52	$19.55	$24.15	$48.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.55 / $32.90 / $85.65	Professional	TC	$15.55	$32.90	$85.65
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $46.16 / $47.90 / $140.12	Professional		$46.16	$47.90	$140.12
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $29.64 / $48.09 / $66.78	Professional	26	$29.64	$48.09	$66.78
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $46.16 / $78.63 / $210.14	Professional	50	$46.16	$78.63	$210.14
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $16.53 / $28.16 / $103.04	Professional	TC	$16.53	$28.16	$103.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.57 / $52.57 / $52.57	Facility		$52.57	$52.57	$52.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.55 / $88.77 / $146.94	Professional		$43.55	$88.77	$146.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.67 / $35.96 / $59.76	Professional	26	$26.67	$35.96	$59.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.59 / $53.21 / $94.00	Professional	TC	$15.59	$53.21	$94.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $57.65 / $71.53 / $127.32	Professional		$57.65	$71.53	$127.32
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.90 / $43.90 / $78.13	Professional	26	$35.90	$43.90	$78.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $21.45 / $27.64 / $49.19	Professional	TC	$21.45	$27.64	$49.19
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $98.95 / $413.75 / $578.65	Facility		$98.95	$413.75	$578.65
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $311.42 / $701.06	Facility		$95.00	$311.42	$701.06
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $19.14 / $28.69 / $85.20	Facility	26	$19.14	$28.69	$85.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $43.55 / $80.09 / $199.22	Professional		$43.55	$80.09	$199.22
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $28.33 / $36.47 / $122.03	Professional	26	$28.33	$36.47	$122.03
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $61.38 / $149.22 / $334.86	Professional	50	$61.38	$149.22	$334.86
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $19.55 / $24.15 / $54.77	Professional	52	$19.55	$24.15	$54.77
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $16.95 / $39.86 / $132.91	Professional	TC	$16.95	$39.86	$132.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.92 / $91.70 / $129.60	Professional		$31.92	$91.70	$129.60
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $52.57 / $52.57 / $52.57	Facility		$52.57	$52.57	$52.57
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $33.84 / $33.84 / $33.84	Facility	26	$33.84	$33.84	$33.84
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $43.55 / $88.52 / $146.94	Professional		$43.55	$88.52	$146.94
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.42 / $36.35 / $63.55	Professional	26	$26.42	$36.35	$63.55
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.59 / $52.02 / $94.00	Professional	TC	$15.59	$52.02	$94.00
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $45.47 / $45.47 / $76.76	Facility		$45.47	$45.47	$76.76
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $29.36 / $29.36 / $30.00	Facility	26	$29.36	$29.36	$30.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $44.78 / $45.47 / $76.76	Professional		$44.78	$45.47	$76.76
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $28.80 / $29.36 / $30.68	Professional	26	$28.80	$29.36	$30.68
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $15.81 / $16.12 / $46.76	Professional	TC	$15.81	$16.12	$46.76
United Facility/Professional Professional Modifier Low / Median / High Price $51.65 / $75.95 / $120.29	Professional		$51.65	$75.95	$120.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.89 / $34.57 / $57.69	Professional	26	$27.89	$34.57	$57.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.63 / $37.21 / $70.14	Professional	TC	$24.63	$37.21	$70.14