Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $25.70 / $44.67	Facility	26	$12.30	$25.70	$44.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $53.70 / $213.80	Professional		$36.31	$53.70	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $21.88 / $45.71	Professional	26	$11.48	$21.88	$45.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.11 / $91.20	Professional	TC	$22.91	$33.11	$91.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $35.48	Professional		$35.48	$35.48	$35.48
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $14.45 / $22.91	Professional	26	$11.22	$14.45	$22.91
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $19.95 / $26.30	Professional	TC	$19.95	$19.95	$26.30
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $43.65 / $74.13	Professional		$42.66	$43.65	$74.13
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $14.13 / $26.92	Professional	26	$13.80	$14.13	$26.92
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $29.51 / $50.12	Professional	TC	$28.84	$29.51	$50.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.39 / $15.85 / $22.39	Facility	26	$3.39	$15.85	$22.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $51.29 / $85.11	Professional		$33.88	$51.29	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.60 / $27.54	Professional	26	$10.23	$16.60	$27.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $34.67 / $56.23	Professional	TC	$21.88	$34.67	$56.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $57.54 / $72.44	Professional		$44.67	$57.54	$72.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $17.78 / $21.88	Professional	26	$13.49	$17.78	$21.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $40.74 / $51.29	Professional	TC	$31.62	$40.74	$51.29
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $48.98 / $89.13	Professional		$33.11	$48.98	$89.13
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.49 / $28.84	Professional	26	$10.96	$15.49	$28.84
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.88 / $60.26	Professional	TC	$21.88	$33.88	$60.26
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $52.48 / $60.26	Professional		$47.86	$52.48	$60.26
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $15.85 / $20.89	Professional	26	$14.45	$15.85	$20.89
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $53.70 / $53.70	Professional	TC	$53.70	$53.70	$53.70
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $12.30 / $25.12 / $44.67	Facility	26	$12.30	$25.12	$44.67
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $54.95 / $120.23	Professional		$36.31	$54.95	$120.23
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $18.62 / $39.81	Professional	26	$11.75	$18.62	$39.81
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $36.31 / $74.13	Professional	TC	$23.99	$36.31	$74.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $58.88 / $85.11	Professional		$26.92	$58.88	$85.11
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $14.45 / $14.45	Facility	26	$14.45	$14.45	$14.45
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $26.30 / $74.13	Professional		$16.22	$26.30	$74.13
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $14.45 / $14.45	Professional	26	$14.45	$14.45	$14.45
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $30.20 / $30.20	Professional	TC	$30.20	$30.20	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $43.65 / $72.44	Professional		$33.88	$43.65	$72.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $15.14 / $25.70	Professional	26	$10.72	$15.14	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $29.51 / $48.98	Professional	TC	$22.91	$29.51	$48.98