Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $154.88 / $154.88	Facility	26	$112.20	$154.88	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $398.11 / $707.95	Professional		$323.59	$398.11	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $112.20 / $223.87	Professional	26	$93.33	$112.20	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $263.03 / $478.63	Professional	TC	$208.93	$263.03	$478.63
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $158.49 / $213.80	Professional	26	$93.33	$158.49	$213.80
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $323.59 / $426.58	Professional	TC	$199.53	$323.59	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $416.87 / $691.83	Professional		$316.23	$416.87	$691.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $141.25 / $208.93	Professional	26	$104.71	$141.25	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $281.84 / $489.78	Professional	TC	$199.53	$281.84	$489.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $512.86 / $562.34	Professional		$398.11	$512.86	$562.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $162.18 / $177.83	Professional	26	$125.89	$162.18	$177.83
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $354.81 / $389.05	Professional	TC	$275.42	$354.81	$389.05
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $436.52 / $630.96	Professional		$295.12	$436.52	$630.96
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $144.54 / $213.80	Professional	26	$109.65	$144.54	$213.80
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $288.40 / $398.11	Professional	TC	$181.97	$288.40	$398.11
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $154.88 / $154.88	Facility	26	$112.20	$154.88	$154.88
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $446.68 / $1,047.13	Professional		$323.59	$446.68	$1,047.13
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $128.82 / $275.42	Professional	26	$97.72	$128.82	$275.42
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $295.12 / $616.60	Professional	TC	$229.09	$295.12	$616.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $575.44 / $691.83	Professional		$338.84	$575.44	$691.83
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $109.65 / $109.65	Facility	26	$102.33	$109.65	$109.65
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $316.23 / $467.74	Professional		$281.84	$316.23	$467.74
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $104.71 / $109.65	Professional	26	$100.00	$104.71	$109.65
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $245.47 / $275.42	Professional	TC	$177.83	$245.47	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $380.19 / $676.08	Professional		$281.84	$380.19	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $128.82 / $213.80	Professional	26	$93.33	$128.82	$213.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $257.04 / $457.09	Professional	TC	$186.21	$257.04	$457.09