Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $107.15 / $213.80	Facility	26	$51.29	$107.15	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $263.03 / $933.25	Professional		$154.88	$263.03	$933.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $97.72 / $223.87	Professional	26	$52.48	$97.72	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $169.82 / $436.52	Professional	TC	$100.00	$169.82	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $57.54 / $89.13	Professional	26	$42.66	$57.54	$89.13
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $199.53 / $398.11	Professional		$151.36	$199.53	$398.11
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $69.18 / $141.25	Professional	26	$53.70	$69.18	$141.25
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $128.82 / $363.08	Professional	TC	$97.72	$128.82	$363.08
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 $147.91 / $281.84 / $489.78	Professional		$147.91	$281.84	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $72.44 / $123.03	Professional	26	$40.74	$72.44	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $190.55 / $380.19	Professional	TC	$95.50	$190.55	$380.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $204.17 / $257.04	Professional		$158.49	$204.17	$257.04
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 $107.15 / $134.90 / $173.78	Professional	TC	$107.15	$134.90	$173.78
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $234.42 / $478.63	Professional		$158.49	$234.42	$478.63
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $69.18 / $128.82	Professional	26	$51.29	$69.18	$128.82
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $165.96 / $346.74	Professional	TC	$100.00	$165.96	$346.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $194.98 / $204.17	Professional		$173.78	$194.98	$204.17
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $67.61 / $100.00	Professional	26	$58.88	$67.61	$100.00
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $186.21 / $302.00	Professional	TC	$186.21	$186.21	$302.00
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $95.50 / $213.80	Facility	26	$53.70	$95.50	$213.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $269.15 / $549.54	Professional		$154.88	$269.15	$549.54
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $81.28 / $181.97	Professional	26	$52.48	$81.28	$181.97
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $173.78 / $398.11	Professional	TC	$102.33	$173.78	$398.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $323.59 / $467.74	Professional		$95.50	$323.59	$467.74
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $53.70 / $70.79	Facility	26	$53.70	$53.70	$70.79
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $177.83 / $338.84	Professional		$75.86	$177.83	$338.84
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $53.70 / $70.79	Professional	26	$51.29	$53.70	$70.79
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $97.72 / $275.42	Professional	TC	$95.50	$97.72	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $218.78 / $371.54	Professional		$144.54	$218.78	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $60.26 / $100.00	Professional	26	$46.77	$60.26	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $134.90 / $269.15	Professional	TC	$93.33	$134.90	$269.15