Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $120.23 / $223.87	Facility	26	$60.26	$120.23	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $302.00 / $977.24	Professional		$190.55	$302.00	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $93.33 / $213.80	Professional	26	$56.23	$93.33	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $218.78 / $549.54	Professional	TC	$134.90	$218.78	$549.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $158.49 / $177.83	Professional		$64.57	$158.49	$177.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $56.23 / $91.20	Professional	26	$47.86	$56.23	$91.20
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $75.86 / $158.49	Professional	26	$58.88	$75.86	$158.49
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $177.83 / $562.34	Professional	TC	$134.90	$177.83	$562.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.45 / $67.61 / $95.50	Facility	26	$14.45	$67.61	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $380.19 / $645.65	Professional		$194.98	$380.19	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $79.43 / $134.90	Professional	26	$44.67	$79.43	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $269.15 / $501.19	Professional	TC	$138.04	$269.15	$501.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $263.03 / $331.13	Professional		$208.93	$263.03	$331.13
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $75.86 / $93.33	Professional	26	$58.88	$75.86	$93.33
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $190.55 / $239.88	Professional	TC	$147.91	$190.55	$239.88
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $588.84	Professional		$199.53	$309.03	$588.84
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $74.13 / $138.04	Professional	26	$56.23	$74.13	$138.04
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $239.88 / $446.68	Professional	TC	$141.25	$239.88	$446.68
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $263.03	Professional		$229.09	$229.09	$263.03
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $69.18 / $87.10	Professional	26	$64.57	$69.18	$87.10
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $208.93 / $208.93	Professional	TC	$208.93	$208.93	$208.93
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $109.65 / $223.87	Facility	26	$60.26	$109.65	$223.87
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $331.13 / $707.95	Professional		$199.53	$331.13	$707.95
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $85.11 / $190.55	Professional	26	$57.54	$85.11	$190.55
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $234.42 / $537.03	Professional	TC	$141.25	$234.42	$537.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $323.59 / $537.03	Professional		$97.72	$323.59	$537.03
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $58.88 / $74.13	Facility	26	$58.88	$58.88	$74.13
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $257.04 / $416.87	Professional		$33.88	$257.04	$416.87
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $58.88 / $74.13	Professional	26	$57.54	$58.88	$74.13
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $138.04 / $338.84	Professional	TC	$134.90	$138.04	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $501.19	Professional		$194.98	$295.12	$501.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $70.79 / $114.82	Professional	26	$53.70	$70.79	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $199.53 / $389.05	Professional	TC	$138.04	$199.53	$389.05