Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.43 / $147.91 / $309.03	Facility	26	$79.43	$147.91	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $389.05 / $1,479.11	Professional		$229.09	$389.05	$1,479.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $104.71 / $295.12	Professional	26	$74.13	$104.71	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $239.88 / $602.56	Professional	TC	$162.18	$239.88	$602.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $177.83 / $181.97	Professional		$109.65	$177.83	$181.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $85.11 / $134.90	Professional	26	$63.10	$85.11	$134.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $162.18 / $162.18	Professional	TC	$162.18	$162.18	$162.18
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $269.15 / $575.44	Professional		$257.04	$269.15	$575.44
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $85.11 / $169.82	Professional	26	$83.18	$85.11	$169.82
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $181.97 / $467.74	Professional	TC	$173.78	$181.97	$467.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $93.33 / $134.90	Facility	26	$19.95	$93.33	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $489.78 / $912.01	Professional		$257.04	$489.78	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $102.33 / $173.78	Professional	26	$63.10	$102.33	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $363.08 / $724.44	Professional	TC	$177.83	$363.08	$724.44
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 $81.28 / $107.15 / $131.83	Professional	26	$81.28	$107.15	$131.83
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $245.47 / $309.03	Professional	TC	$190.55	$245.47	$309.03
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $371.54 / $741.31	Professional		$269.15	$371.54	$741.31
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $97.72 / $177.83	Professional	26	$70.79	$97.72	$177.83
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $281.84 / $524.81	Professional	TC	$181.97	$281.84	$524.81
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $338.84 / $371.54	Professional		$316.23	$338.84	$371.54
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $97.72 / $141.25	Professional	26	$91.20	$97.72	$141.25
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 $79.43 / $138.04 / $295.12	Facility	26	$79.43	$138.04	$295.12
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $389.05 / $851.14	Professional		$251.19	$389.05	$851.14
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $107.15 / $251.19	Professional	26	$75.86	$107.15	$251.19
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $269.15 / $562.34	Professional	TC	$169.82	$269.15	$562.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $323.59 / $870.96	Professional		$177.83	$323.59	$870.96
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $83.18 / $91.20	Facility	26	$83.18	$83.18	$91.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $251.19 / $346.74	Professional		$181.97	$251.19	$346.74
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $83.18 / $91.20	Professional	26	$79.43	$83.18	$91.20
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $169.82 / $380.19	Professional	TC	$165.96	$169.82	$380.19
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $380.19 / $676.08	Professional		$257.04	$380.19	$676.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $91.20 / $147.91	Professional	26	$69.18	$91.20	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $257.04 / $524.81	Professional	TC	$177.83	$257.04	$524.81