Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $229.09 / $426.58	Facility	26	$112.20	$229.09	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $691.83 / $3,162.28	Professional		$426.58	$691.83	$3,162.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $190.55 / $389.05	Professional	26	$107.15	$190.55	$389.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $446.68 / $977.24	Professional	TC	$295.12	$446.68	$977.24
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Professional	26	$154.88	$154.88	$154.88
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $478.63 / $1,348.96	Professional		$457.09	$478.63	$1,348.96
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $141.25 / $263.03	Professional	26	$107.15	$141.25	$263.03
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $363.08 / $1,096.48	Professional	TC	$354.81	$363.08	$1,096.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $123.03 / $173.78	Facility	26	$26.30	$123.03	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $851.14 / $1,513.56	Professional		$446.68	$851.14	$1,513.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $131.83 / $218.78	Professional	26	$79.43	$131.83	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $691.83 / $1,230.27	Professional	TC	$354.81	$691.83	$1,230.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $630.96 / $776.25	Professional		$489.78	$630.96	$776.25
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $138.04 / $169.82	Professional	26	$104.71	$138.04	$169.82
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $489.78 / $616.60	Professional	TC	$380.19	$489.78	$616.60
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $676.08 / $1,258.93	Professional		$457.09	$676.08	$1,258.93
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $128.82 / $229.09	Professional	26	$91.20	$128.82	$229.09
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $537.03 / $977.24	Professional	TC	$346.74	$537.03	$977.24
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $616.60 / $1,000.00	Professional		$537.03	$616.60	$1,000.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $131.83 / $208.93	Professional	26	$120.23	$131.83	$208.93
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $199.53 / $416.87	Facility	26	$112.20	$199.53	$416.87
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $676.08 / $1,621.81	Professional		$426.58	$676.08	$1,621.81
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $165.96 / $338.84	Professional	26	$107.15	$165.96	$338.84
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $501.19 / $1,071.52	Professional	TC	$302.00	$501.19	$1,071.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $707.95 / $1,174.90	Professional		$707.95	$707.95	$1,174.90
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $120.23 / $120.23	Facility	26	$107.15	$120.23	$120.23
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $446.68 / $1,023.29	Professional		$436.52	$446.68	$1,023.29
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $107.15 / $120.23	Professional	26	$102.33	$107.15	$120.23
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $354.81 / $912.01	Professional	TC	$338.84	$354.81	$912.01
United Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $676.08 / $1,230.27	Professional		$467.74	$676.08	$1,230.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $114.82 / $204.17	Professional	26	$91.20	$114.82	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $537.03 / $1,000.00	Professional	TC	$363.08	$537.03	$1,000.00