Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $114.82 / $229.09	Facility	26	$53.70	$114.82	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $302.00 / $891.25	Professional		$181.97	$302.00	$891.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $95.50 / $234.42	Professional	26	$53.70	$95.50	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $213.80 / $489.78	Professional	TC	$123.03	$213.80	$489.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $56.23 / $87.10	Professional	26	$43.65	$56.23	$87.10
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $181.97 / $489.78	Professional		$177.83	$181.97	$489.78
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $54.95 / $128.82	Professional	26	$53.70	$54.95	$128.82
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $128.82 / $371.54	Professional	TC	$123.03	$128.82	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $60.26 / $87.10	Facility	26	$13.18	$60.26	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $331.13 / $588.84	Professional		$186.21	$331.13	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $77.62 / $131.83	Professional	26	$42.66	$77.62	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $245.47 / $446.68	Professional	TC	$131.83	$245.47	$446.68
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $245.47 / $309.03	Professional		$190.55	$245.47	$309.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $69.18 / $85.11	Professional	26	$52.48	$69.18	$85.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $173.78 / $218.78	Professional	TC	$138.04	$173.78	$218.78
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $257.04 / $537.03	Professional		$186.21	$257.04	$537.03
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $70.79 / $128.82	Professional	26	$53.70	$70.79	$128.82
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $181.97 / $398.11	Professional	TC	$128.82	$181.97	$398.11
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $239.88 / $239.88	Professional		$229.09	$239.88	$239.88
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $66.07 / $91.20	Professional	26	$60.26	$66.07	$91.20
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $107.15 / $229.09	Facility	26	$53.70	$107.15	$229.09
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $316.23 / $660.69	Professional		$181.97	$316.23	$660.69
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $83.18 / $190.55	Professional	26	$53.70	$83.18	$190.55
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $218.78 / $478.63	Professional	TC	$128.82	$218.78	$478.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $323.59 / $549.54	Professional		$117.49	$323.59	$549.54
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $53.70 / $75.86	Facility	26	$53.70	$53.70	$75.86
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $181.97 / $338.84	Professional		$177.83	$181.97	$338.84
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $53.70 / $75.86	Professional	26	$51.29	$53.70	$75.86
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $125.89 / $288.40	Professional	TC	$123.03	$125.89	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $263.03 / $436.52	Professional		$186.21	$263.03	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $63.10 / $104.71	Professional	26	$47.86	$63.10	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $194.98 / $354.81	Professional	TC	$134.90	$194.98	$354.81