Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $190.55 / $426.58	Facility	26	$91.20	$190.55	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $524.81 / $1,548.82	Professional		$338.84	$524.81	$1,548.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $141.25 / $295.12	Professional	26	$70.79	$141.25	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $371.54 / $870.96	Professional	TC	$263.03	$371.54	$870.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $97.72 / $131.83	Professional	26	$61.66	$97.72	$131.83
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $338.84 / $1,096.48	Professional		$323.59	$338.84	$1,096.48
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $72.44 / $173.78	Professional	26	$69.18	$72.44	$173.78
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $263.03 / $1,023.29	Professional	TC	$251.19	$263.03	$1,023.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $114.82	Facility	26	$16.98	$79.43	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $707.95 / $1,380.38	Professional		$338.84	$707.95	$1,380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $100.00 / $173.78	Professional	26	$56.23	$100.00	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $602.56 / $1,202.26	Professional	TC	$263.03	$602.56	$1,202.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $446.68 / $562.34	Professional		$346.74	$446.68	$562.34
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $91.20 / $109.65	Professional	26	$69.18	$91.20	$109.65
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $354.81 / $446.68	Professional	TC	$281.84	$354.81	$446.68
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $537.03 / $977.24	Professional		$338.84	$537.03	$977.24
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $93.33 / $169.82	Professional	26	$69.18	$93.33	$169.82
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $446.68 / $831.76	Professional	TC	$263.03	$446.68	$831.76
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $416.87 / $1,023.29	Professional		$380.19	$416.87	$1,023.29
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 $467.74 / $467.74 / $467.74	Professional	TC	$467.74	$467.74	$467.74
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $186.21 / $416.87	Facility	26	$91.20	$186.21	$416.87
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $537.03 / $1,288.25	Professional		$346.74	$537.03	$1,288.25
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $125.89 / $257.04	Professional	26	$72.44	$125.89	$257.04
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $398.11 / $933.25	Professional	TC	$269.15	$398.11	$933.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $588.84 / $1,258.93	Professional		$114.82	$588.84	$1,258.93
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $69.18 / $95.50	Facility	26	$69.18	$69.18	$95.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $323.59 / $354.81	Professional		$229.09	$323.59	$354.81
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $69.18 / $72.44	Professional	26	$67.61	$69.18	$72.44
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $257.04 / $288.40	Professional	TC	$251.19	$257.04	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $489.78 / $1,023.29	Professional		$302.00	$489.78	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $83.18 / $138.04	Professional	26	$60.26	$83.18	$138.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $380.19 / $891.25	Professional	TC	$239.88	$380.19	$891.25