Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $38.02 / $66.07	Facility	26	$19.05	$38.02	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $251.19	Professional		$72.44	$109.65	$251.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $27.54 / $66.07	Professional	26	$16.98	$27.54	$66.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $79.43 / $173.78	Professional	TC	$54.95	$79.43	$173.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $89.13	Professional		$85.11	$85.11	$89.13
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $97.72 / $165.96	Professional		$95.50	$97.72	$165.96
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $20.89 / $38.90	Professional	26	$19.95	$20.89	$38.90
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $77.62 / $131.83	Professional	TC	$74.13	$77.62	$131.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.90 / $22.91 / $32.36	Facility	26	$4.90	$22.91	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $102.33 / $186.21	Professional		$70.79	$102.33	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $25.12 / $40.74	Professional	26	$14.79	$25.12	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $79.43 / $147.91	Professional	TC	$56.23	$79.43	$147.91
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $169.82	Professional		$104.71	$134.90	$169.82
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.30 / $32.36	Professional	26	$19.95	$26.30	$32.36
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $107.15 / $134.90	Professional	TC	$85.11	$107.15	$134.90
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $102.33 / $204.17	Professional		$61.66	$102.33	$204.17
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $22.39 / $42.66	Professional	26	$16.22	$22.39	$42.66
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $79.43 / $158.49	Professional	TC	$44.67	$79.43	$158.49
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Professional		$125.89	$125.89	$125.89
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $23.99 / $25.70	Professional	26	$21.88	$23.99	$25.70
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $36.31 / $66.07	Facility	26	$19.05	$36.31	$66.07
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $117.49 / $239.88	Professional		$75.86	$117.49	$239.88
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $25.70 / $54.95	Professional	26	$16.98	$25.70	$54.95
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $89.13 / $181.97	Professional	TC	$58.88	$89.13	$181.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $77.62 / $177.83	Professional		$21.38	$77.62	$177.83
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $22.39 / $22.39	Facility	26	$19.95	$22.39	$22.39
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $87.10 / $309.03	Professional		$17.38	$87.10	$309.03
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $20.42 / $22.39	Professional	26	$19.50	$20.42	$22.39
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $74.13 / $83.18	Professional	TC	$61.66	$74.13	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $93.33 / $158.49	Professional		$70.79	$93.33	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $21.88 / $37.15	Professional	26	$16.60	$21.88	$37.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $72.44 / $123.03	Professional	TC	$53.70	$72.44	$123.03