Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $19.05 / $39.81	Facility	26	$9.55	$19.05	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $53.70 / $213.80	Professional		$33.11	$53.70	$213.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $17.38 / $38.90	Professional	26	$8.91	$17.38	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $39.81 / $123.03	Professional	TC	$23.99	$39.81	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $28.84 / $29.51	Professional		$26.30	$28.84	$29.51
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $15.85 / $16.60	Professional	26	$9.33	$15.85	$16.60
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $25.70 / $30.20	Professional	TC	$25.70	$25.70	$30.20
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $51.29 / $75.86	Professional		$38.90	$51.29	$75.86
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $13.18 / $25.70	Professional	26	$10.72	$13.18	$25.70
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $37.15 / $57.54	Professional	TC	$28.84	$37.15	$57.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.63 / $12.30 / $17.38	Facility	26	$2.63	$12.30	$17.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $52.48 / $85.11	Professional		$32.36	$52.48	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $13.49 / $22.39	Professional	26	$8.51	$13.49	$22.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $39.81 / $63.10	Professional	TC	$24.55	$39.81	$63.10
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 $10.96 / $14.13 / $17.38	Professional	26	$10.96	$14.13	$17.38
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $42.66 / $54.95	Professional	TC	$33.88	$42.66	$54.95
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $50.12 / $89.13	Professional		$34.67	$50.12	$89.13
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.88 / $23.44	Professional	26	$8.91	$12.88	$23.44
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $36.31 / $64.57	Professional	TC	$25.70	$36.31	$64.57
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $48.98 / $57.54	Professional		$44.67	$48.98	$57.54
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $12.59 / $16.22	Professional	26	$11.22	$12.59	$16.22
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $36.31 / $42.66	Professional	TC	$36.31	$36.31	$42.66
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $15.85 / $39.81	Facility	26	$9.55	$15.85	$39.81
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $56.23 / $120.23	Professional		$34.67	$56.23	$120.23
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.14 / $31.62	Professional	26	$8.91	$15.14	$31.62
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $41.69 / $79.43	Professional	TC	$25.12	$41.69	$79.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $57.54 / $83.18	Professional		$11.75	$57.54	$83.18
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $10.72 / $12.02	Facility	26	$10.72	$10.72	$12.02
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $23.99 / $69.18	Professional		$19.05	$23.99	$69.18
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.72 / $12.02	Professional	26	$10.23	$10.72	$12.02
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $28.18 / $34.67	Professional	TC	$28.18	$28.18	$34.67
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $43.65 / $70.79	Professional		$33.88	$43.65	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.75 / $20.42	Professional	26	$8.91	$11.75	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $31.62 / $52.48	Professional	TC	$23.99	$31.62	$52.48