Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $135.44 / $245.74	Facility		$22.91	$135.44	$245.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.71 / $2.98 / $2.98	Facility	26	$2.71	$2.98	$2.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $29.81 / $81.00	Professional		$19.95	$29.81	$81.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.71 / $3.77 / $16.14	Professional	26	$2.71	$3.77	$16.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.30 / $10.95 / $15.52	Professional	52	$9.30	$10.95	$15.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.30 / $23.16 / $37.97	Professional	TC	$16.30	$23.16	$37.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.56 / $20.56 / $26.27	Professional		$20.56	$20.56	$26.27
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 $22.06 / $22.89 / $74.36	Professional		$22.06	$22.89	$74.36
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $2.99 / $4.83 / $25.26	Professional	26	$2.99	$4.83	$25.26
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $22.06 / $31.79 / $74.36	Professional	50	$22.06	$31.79	$74.36
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $19.07 / $27.41 / $55.17	Professional	TC	$19.07	$27.41	$55.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $26.10 / $26.10 / $26.10	Facility		$26.10	$26.10	$26.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.41 / $3.41 / $3.41	Facility	26	$3.41	$3.41	$3.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.98 / $35.49 / $60.21	Professional		$18.98	$35.49	$60.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.70 / $5.01 / $14.48	Professional	26	$2.70	$5.01	$14.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.94 / $29.93 / $47.33	Professional	TC	$15.94	$29.93	$47.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $27.16 / $35.34 / $45.83	Professional		$27.16	$35.34	$45.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $3.50 / $4.37 / $6.03	Professional	26	$3.50	$4.37	$6.03
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.67 / $30.77 / $39.82	Professional	TC	$23.67	$30.77	$39.82
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.41 / $158.61 / $198.72	Facility		$77.41	$158.61	$198.72
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $127.01 / $135.62 / $245.74	Facility		$127.01	$135.62	$245.74
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $2.98 / $2.98 / $2.98	Facility	26	$2.98	$2.98	$2.98
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $21.18 / $31.01 / $86.43	Professional		$21.18	$31.01	$86.43
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $2.84 / $4.23 / $17.88	Professional	26	$2.84	$4.23	$17.88
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $9.31 / $11.21 / $31.72	Professional	52	$9.31	$11.21	$31.72
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $17.23 / $24.51 / $59.22	Professional	TC	$17.23	$24.51	$59.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.64 / $41.62 / $79.40	Professional		$5.64	$41.62	$79.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $26.10 / $26.10 / $46.98	Facility		$26.10	$26.10	$46.98
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $3.41 / $3.41 / $11.28	Facility	26	$3.41	$3.41	$11.28
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $18.98 / $34.54 / $65.62	Professional		$18.98	$34.54	$65.62
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2.45 / $4.78 / $14.39	Professional	26	$2.45	$4.78	$14.39
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $15.94 / $29.69 / $47.76	Professional	TC	$15.94	$29.69	$47.76
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $21.91 / $21.91 / $52.22	Facility		$21.91	$21.91	$52.22
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $2.95 / $2.95 / $14.00	Facility	26	$2.95	$2.95	$14.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $21.58 / $21.91 / $52.22	Professional		$21.58	$21.91	$52.22
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $2.84 / $2.98 / $14.00	Professional	26	$2.84	$2.98	$14.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $18.59 / $18.96 / $38.22	Professional	TC	$18.59	$18.96	$38.22
United Facility/Professional Professional Modifier Low / Median / High Price $20.05 / $27.50 / $49.96	Professional		$20.05	$27.50	$49.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.02 / $3.93 / $10.97	Professional	26	$3.02	$3.93	$10.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.03 / $22.41 / $38.31	Professional	TC	$17.03	$22.41	$38.31