Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $245.47 / $467.74	Facility	26	$114.82	$245.47	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $478.63 / $1,778.28	Professional		$281.84	$478.63	$1,778.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $309.03	Professional	26	$85.11	$141.25	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $331.13 / $691.83	Professional	TC	$190.55	$331.13	$691.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $79.43 / $138.04	Professional	26	$69.18	$79.43	$138.04
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $380.19 / $758.58	Professional		$269.15	$380.19	$758.58
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $112.20 / $208.93	Professional	26	$85.11	$112.20	$208.93
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $269.15 / $851.14	Professional	TC	$181.97	$269.15	$851.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $95.50 / $138.04	Facility	26	$20.42	$95.50	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $512.86 / $912.01	Professional		$263.03	$512.86	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $104.71 / $173.78	Professional	26	$63.10	$104.71	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $380.19 / $776.25	Professional	TC	$177.83	$380.19	$776.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $363.08 / $457.09	Professional		$281.84	$363.08	$457.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $109.65 / $131.83	Professional	26	$83.18	$109.65	$131.83
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $257.04 / $323.59	Professional	TC	$199.53	$257.04	$323.59
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $812.83	Professional		$275.42	$426.58	$812.83
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $100.00 / $181.97	Professional	26	$72.44	$100.00	$181.97
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $338.84 / $602.56	Professional	TC	$190.55	$338.84	$602.56
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $616.60	Professional		$316.23	$316.23	$616.60
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $102.33 / $158.49	Professional	26	$91.20	$102.33	$158.49
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $223.87 / $426.58	Facility	26	$117.49	$223.87	$426.58
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $478.63 / $1,071.52	Professional		$295.12	$478.63	$1,071.52
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $275.42	Professional	26	$85.11	$141.25	$275.42
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $338.84 / $724.44	Professional	TC	$199.53	$338.84	$724.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $489.78 / $707.95	Professional		$138.04	$489.78	$707.95
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $97.72 / $97.72	Facility	26	$83.18	$97.72	$97.72
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $380.19 / $416.87	Professional		$117.49	$380.19	$416.87
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $83.18 / $97.72	Professional	26	$81.28	$83.18	$97.72
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $186.21 / $512.86	Professional	TC	$181.97	$186.21	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $389.05 / $724.44	Professional		$263.03	$389.05	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $91.20 / $162.18	Professional	26	$72.44	$91.20	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $269.15 / $575.44	Professional	TC	$186.21	$269.15	$575.44