Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.33 / $382.16 / $1,362.75	Facility		$71.33	$382.16	$1,362.75
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.34 / $19.34 / $25.69	Facility	26	$19.34	$19.34	$25.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.56 / $102.33 / $209.22	Professional		$60.56	$102.33	$209.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.90 / $17.98 / $28.45	Professional	26	$15.90	$17.98	$28.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.33 / $69.53 / $147.29	Professional	TC	$43.33	$69.53	$147.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.95 / $63.95 / $63.95	Professional		$63.95	$63.95	$63.95
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 $63.81 / $102.31 / $202.00	Professional		$63.81	$102.31	$202.00
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $18.04 / $26.38 / $43.78	Professional	26	$18.04	$26.38	$43.78
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $45.77 / $72.54 / $171.54	Professional	TC	$45.77	$72.54	$171.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.31 / $75.31 / $167.67	Facility		$75.31	$75.31	$167.67
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.65 / $20.65 / $20.65	Facility	26	$20.65	$20.65	$20.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.20 / $113.93 / $208.53	Professional		$60.20	$113.93	$208.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.02 / $22.97 / $40.29	Professional	26	$17.02	$22.97	$40.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.69 / $90.22 / $169.62	Professional	TC	$44.69	$90.22	$169.62
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $99.70 / $132.85	Professional		$68.20	$99.70	$132.85
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.69 / $26.16 / $35.51	Professional	26	$17.69	$26.16	$35.51
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.51 / $73.53 / $95.76	Professional	TC	$50.51	$73.53	$95.76
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $622.63 / $845.71 / $1,747.45	Facility		$622.63	$845.71	$1,747.45
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.94 / $33.47 / $37.53	Professional	26	$21.94	$33.47	$37.53
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $89.65 / $382.16 / $1,519.44	Facility		$89.65	$382.16	$1,519.44
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $19.34 / $25.69 / $57.43	Facility	26	$19.34	$25.69	$57.43
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $61.83 / $115.70 / $272.17	Professional		$61.83	$115.70	$272.17
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $16.67 / $19.07 / $46.50	Professional	26	$16.67	$19.07	$46.50
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $44.11 / $69.53 / $160.25	Professional	TC	$44.11	$69.53	$160.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $18.80 / $61.22 / $117.37	Professional		$18.80	$61.22	$117.37
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $75.31 / $75.31 / $167.67	Facility		$75.31	$75.31	$167.67
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.57 / $20.65 / $20.65	Facility	26	$19.57	$20.65	$20.65
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $60.20 / $115.35 / $218.69	Professional		$60.20	$115.35	$218.69
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.14 / $22.97 / $42.03	Professional	26	$17.14	$22.97	$42.03
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.34 / $89.40 / $190.31	Professional	TC	$45.34	$89.40	$190.31
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $63.38 / $63.38 / $100.65	Facility		$63.38	$63.38	$100.65
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $17.86 / $17.86 / $40.20	Facility	26	$17.86	$17.86	$40.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $62.34 / $63.38 / $68.72	Professional		$62.34	$63.38	$68.72
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $17.48 / $17.86 / $18.60	Professional	26	$17.48	$17.86	$18.60
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $44.55 / $45.52 / $50.11	Professional	TC	$44.55	$45.52	$50.11
United Facility/Professional Professional Modifier Low / Median / High Price $57.67 / $81.48 / $137.46	Professional		$57.67	$81.48	$137.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.23 / $20.89 / $35.04	Professional	26	$16.23	$20.89	$35.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.18 / $64.53 / $114.80	Professional	TC	$43.18	$64.53	$114.80