Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $154.88 / $281.84	Facility	26	$74.13	$154.88	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $338.84 / $1,412.54	Professional		$218.78	$338.84	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $109.65 / $245.47	Professional	26	$66.07	$109.65	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $218.78 / $537.03	Professional	TC	$144.54	$218.78	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $177.83 / $181.97	Professional		$144.54	$177.83	$181.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $67.61 / $89.13	Professional	26	$61.66	$67.61	$89.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $97.72 / $97.72	Professional	TC	$97.72	$97.72	$97.72
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $575.44	Professional		$218.78	$288.40	$575.44
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $87.10 / $165.96	Professional	26	$75.86	$87.10	$165.96
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $190.55 / $446.68	Professional	TC	$141.25	$190.55	$446.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.62 / $87.10 / $123.03	Facility	26	$18.62	$87.10	$123.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $371.54 / $630.96	Professional		$204.17	$371.54	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $87.10 / $151.36	Professional	26	$54.95	$87.10	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $263.03 / $478.63	Professional	TC	$141.25	$263.03	$478.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $295.12 / $371.54	Professional		$229.09	$295.12	$371.54
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $97.72 / $120.23	Professional	26	$74.13	$97.72	$120.23
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $199.53 / $251.19	Professional	TC	$154.88	$199.53	$251.19
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $309.03 / $616.60	Professional		$229.09	$309.03	$616.60
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $158.49	Professional	26	$58.88	$85.11	$158.49
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $213.80 / $446.68	Professional	TC	$147.91	$213.80	$446.68
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $257.04 / $281.84	Professional		$257.04	$257.04	$281.84
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $87.10 / $112.20	Professional	26	$83.18	$87.10	$112.20
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $138.04 / $275.42	Facility	26	$77.62	$138.04	$275.42
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $346.74 / $758.58	Professional		$223.87	$346.74	$758.58
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $102.33 / $208.93	Professional	26	$70.79	$102.33	$208.93
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $234.42 / $501.19	Professional	TC	$147.91	$234.42	$501.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $323.59 / $575.44	Professional		$134.90	$323.59	$575.44
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $79.43 / $79.43	Facility	26	$75.86	$79.43	$79.43
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $223.87 / $380.19	Professional		$91.20	$223.87	$380.19
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $77.62 / $79.43	Professional	26	$74.13	$77.62	$79.43
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $147.91 / $302.00	Professional	TC	$141.25	$147.91	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $295.12 / $478.63	Professional		$213.80	$295.12	$478.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $83.18 / $134.90	Professional	26	$60.26	$83.18	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $199.53 / $371.54	Professional	TC	$138.04	$199.53	$371.54