Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $363.08 / $1,047.13	Facility		$112.20	$363.08	$1,047.13
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $30.20 / $70.79	Facility	26	$20.89	$30.20	$70.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $109.65 / $275.42 / $741.31	Facility	TC	$109.65	$275.42	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $131.83 / $457.09	Professional		$22.91	$131.83	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $28.84 / $89.13	Professional	26	$19.95	$28.84	$89.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $117.49 / $309.03	Professional	TC	$89.13	$117.49	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $93.33 / $162.18	Professional		$77.62	$93.33	$162.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $19.50 / $31.62	Professional	26	$16.22	$19.50	$31.62
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $77.62 / $144.54	Professional	TC	$53.70	$77.62	$144.54
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $5,011.87 / $77,624.71	Facility		$114.82	$5,011.87	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $162.18 / $275.42	Professional		$134.90	$162.18	$275.42
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $27.54 / $44.67	Professional	26	$24.55	$27.54	$44.67
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $131.83 / $223.87	Professional	TC	$109.65	$131.83	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $234.42 / $331.13	Facility		$107.15	$234.42	$331.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.13 / $23.99 / $33.88	Facility	26	$5.13	$23.99	$33.88
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $104.71 / $151.36	Facility	TC	$22.91	$104.71	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $165.96 / $269.15	Professional		$112.20	$165.96	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.92 / $42.66	Professional	26	$19.95	$26.92	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $144.54 / $229.09	Professional	TC	$93.33	$144.54	$229.09
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $204.17	Professional		$138.04	$162.18	$204.17
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $28.84 / $34.67	Professional	26	$23.99	$28.84	$34.67
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $131.83 / $169.82	Professional	TC	$114.82	$131.83	$169.82
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
Geisinger Facility/Professional Facility Modifier TC Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	TC	$165.96	$165.96	$165.96
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $151.36 / $229.09	Professional		$107.15	$151.36	$229.09
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $27.54 / $42.66	Professional	26	$20.42	$27.54	$42.66
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $123.03 / $186.21	Professional	TC	$87.10	$123.03	$186.21
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $275.42 / $512.86	Facility		$134.90	$275.42	$512.86
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $38.90 / $38.90	Facility	26	$38.90	$38.90	$38.90
Highmark BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $204.17 / $389.05 / $645.65	Facility	TC	$204.17	$389.05	$645.65
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $138.04 / $151.36	Professional		$125.89	$138.04	$151.36
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $24.55 / $33.88	Professional	26	$22.39	$24.55	$33.88
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $141.25 / $181.97	Professional	TC	$123.03	$141.25	$181.97
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $912.01 / $4,073.80	Facility		$120.23	$912.01	$4,073.80
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $21.88 / $30.90	Professional	26	$21.88	$21.88	$30.90
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $346.74 / $912.01	Facility		$114.82	$346.74	$912.01
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $30.20 / $67.61	Facility	26	$20.89	$30.20	$67.61
Martin's Point Facility/Professional Facility Modifier TC Low / Median / High Price $107.15 / $295.12 / $794.33	Facility	TC	$107.15	$295.12	$794.33
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $147.91 / $331.13	Professional		$36.31	$147.91	$331.13
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $28.84 / $75.86	Professional	26	$19.95	$28.84	$75.86
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $128.82 / $245.47	Professional	TC	$91.20	$128.82	$245.47
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $1,862.09 / $2,344.23	Facility		$812.83	$1,862.09	$2,344.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $177.83 / $257.04	Professional		$41.69	$177.83	$257.04
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $60.26 / $338.84	Facility		$15.85	$60.26	$338.84
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $20.89 / $30.90	Facility	26	$20.89	$20.89	$30.90
UPMC Health Plan Facility/Professional Facility Modifier TC Low / Median / High Price $93.33 / $93.33 / $147.91	Facility	TC	$93.33	$93.33	$147.91
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $87.10 / $338.84	Professional		$37.15	$87.10	$338.84
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $20.89 / $30.90	Professional	26	$20.89	$20.89	$30.90
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $93.33 / $147.91	Professional	TC	$91.20	$93.33	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $295.12 / $371.54	Facility		$158.49	$295.12	$371.54
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $141.25 / $239.88	Professional		$107.15	$141.25	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $23.99 / $41.69	Professional	26	$19.05	$23.99	$41.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $117.49 / $204.17	Professional	TC	$87.10	$117.49	$204.17