Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $338.84 / $870.96	Facility		$114.82	$338.84	$870.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $39.81 / $93.33	Facility	26	$23.99	$39.81	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $147.91 / $331.13	Professional		$107.15	$147.91	$331.13
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $30.90 / $74.13	Professional	26	$20.89	$30.90	$74.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $107.15 / $194.98	Professional	TC	$85.11	$107.15	$194.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $87.10 / $100.00	Professional		$69.18	$87.10	$100.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $25.12 / $33.88	Professional	26	$25.12	$25.12	$33.88
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,511.38 / $77,624.71	Facility		$5,011.87	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $117.49 / $213.80	Professional		$100.00	$117.49	$213.80
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $23.99 / $45.71	Professional	26	$20.42	$23.99	$45.71
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $93.33 / $165.96	Professional	TC	$77.62	$93.33	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $229.09 / $316.23	Facility		$102.33	$229.09	$316.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	26	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $165.96 / $269.15	Professional		$109.65	$165.96	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $27.54 / $45.71	Professional	26	$21.88	$27.54	$45.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $141.25 / $229.09	Professional	TC	$89.13	$141.25	$229.09
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $162.18 / $208.93	Professional		$141.25	$162.18	$208.93
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $32.36 / $39.81	Professional	26	$26.92	$32.36	$39.81
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $147.91 / $190.55	Professional	TC	$112.20	$147.91	$190.55
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $151.36 / $239.88	Professional		$114.82	$151.36	$239.88
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $29.51 / $46.77	Professional	26	$22.91	$29.51	$46.77
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $120.23 / $190.55	Professional	TC	$91.20	$120.23	$190.55
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $338.84 / $489.78	Facility		$234.42	$338.84	$489.78
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $26.30 / $316.23	Professional	26	$26.30	$26.30	$316.23
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $309.03 / $794.33	Facility		$112.20	$309.03	$794.33
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $33.88 / $83.18	Facility	26	$23.99	$33.88	$83.18
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $162.18 / $331.13	Professional		$109.65	$162.18	$331.13
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $33.11 / $67.61	Professional	26	$21.38	$33.11	$67.61
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $125.89 / $257.04	Professional	TC	$87.10	$125.89	$257.04
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $251.19	Facility		$239.88	$239.88	$251.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $223.87 / $323.59	Professional		$154.88	$223.87	$323.59
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $79.43 / $134.90	Facility		$52.48	$79.43	$134.90
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $22.39 / $26.30 / $26.30	Facility	26	$22.39	$26.30	$26.30
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $53.70 / $134.90	Professional		$26.30	$53.70	$134.90
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $26.30 / $26.30	Professional	26	$22.39	$26.30	$26.30
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $107.15 / $107.15	Professional	TC	$87.10	$107.15	$107.15
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 $104.71 / $138.04 / $234.42	Professional		$104.71	$138.04	$234.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $25.70 / $44.67	Professional	26	$20.42	$25.70	$44.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $114.82 / $199.53	Professional	TC	$83.18	$114.82	$199.53