Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $239.88 / $467.74	Facility	26	$97.72	$239.88	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $478.63 / $1,737.80	Professional		$275.42	$478.63	$1,737.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $123.03 / $288.40	Professional	26	$70.79	$123.03	$288.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $338.84 / $851.14	Professional	TC	$199.53	$338.84	$851.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $208.93	Professional		$173.78	$173.78	$208.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $56.23 / $112.20	Professional	26	$56.23	$56.23	$112.20
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $269.15 / $588.84	Professional		$257.04	$269.15	$588.84
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $72.44 / $141.25	Professional	26	$69.18	$72.44	$141.25
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $194.98 / $489.78	Professional	TC	$186.21	$194.98	$489.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $112.20	Facility	26	$16.98	$79.43	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $467.74 / $812.83	Professional		$245.47	$467.74	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $87.10 / $144.54	Professional	26	$52.48	$87.10	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $354.81 / $645.65	Professional	TC	$186.21	$354.81	$645.65
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $354.81 / $436.52	Professional		$275.42	$354.81	$436.52
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $89.13 / $109.65	Professional	26	$67.61	$89.13	$109.65
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $263.03 / $331.13	Professional	TC	$204.17	$263.03	$331.13
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $363.08 / $724.44	Professional		$269.15	$363.08	$724.44
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $83.18 / $147.91	Professional	26	$60.26	$83.18	$147.91
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $295.12 / $537.03	Professional	TC	$194.98	$295.12	$537.03
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $309.03 / $549.54	Professional		$302.00	$309.03	$549.54
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $85.11 / $120.23	Professional	26	$77.62	$85.11	$120.23
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $354.81 / $354.81	Professional	TC	$354.81	$354.81	$354.81
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $186.21 / $426.58	Facility	26	$91.20	$186.21	$426.58
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $478.63 / $1,096.48	Professional		$275.42	$478.63	$1,096.48
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $125.89 / $229.09	Professional	26	$70.79	$125.89	$229.09
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $338.84 / $691.83	Professional	TC	$204.17	$338.84	$691.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $707.95 / $758.58	Professional		$467.74	$707.95	$758.58
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $323.59 / $501.19	Professional		$302.00	$323.59	$501.19
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Professional	26	$77.62	$77.62	$77.62
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $426.58 / $426.58 / $426.58	Professional	TC	$426.58	$426.58	$426.58
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $380.19 / $630.96	Professional		$263.03	$380.19	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $75.86 / $134.90	Professional	26	$60.26	$75.86	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $281.84 / $524.81	Professional	TC	$194.98	$281.84	$524.81