Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $89.13 / $194.98	Facility	26	$45.71	$89.13	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $239.88 / $870.96	Professional		$131.83	$239.88	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $60.26 / $190.55	Professional	26	$43.65	$60.26	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $141.25 / $398.11	Professional	TC	$83.18	$141.25	$398.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $93.33 / $117.49	Professional		$87.10	$93.33	$117.49
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $43.65 / $74.13	Professional	26	$36.31	$43.65	$74.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $89.13 / $104.71	Professional	TC	$89.13	$89.13	$104.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $331.13 / $478.63	Professional		$229.09	$331.13	$478.63
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $69.18 / $131.83	Professional	26	$46.77	$69.18	$131.83
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $128.82 / $371.54	Professional	TC	$81.28	$128.82	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $53.70 / $75.86	Facility	26	$11.48	$53.70	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $257.04 / $436.52	Professional		$131.83	$257.04	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $64.57 / $107.15	Professional	26	$36.31	$64.57	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $173.78 / $323.59	Professional	TC	$85.11	$173.78	$323.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $177.83 / $218.78	Professional		$138.04	$177.83	$218.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $61.66 / $75.86	Professional	26	$46.77	$61.66	$75.86
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $114.82 / $144.54	Professional	TC	$91.20	$114.82	$144.54
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $213.80 / $389.05	Professional		$134.90	$213.80	$389.05
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $61.66 / $114.82	Professional	26	$45.71	$61.66	$114.82
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $162.18 / $288.40	Professional	TC	$85.11	$162.18	$288.40
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $165.96 / $173.78	Professional		$154.88	$165.96	$173.78
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $57.54 / $83.18	Professional	26	$51.29	$57.54	$83.18
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $151.36 / $158.49	Professional	TC	$125.89	$151.36	$158.49
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $56.23 / $75.86	Professional	26	$51.29	$56.23	$75.86
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $81.28 / $173.78	Facility	26	$45.71	$81.28	$173.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $234.42 / $537.03	Professional		$138.04	$234.42	$537.03
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $61.66 / $162.18	Professional	26	$44.67	$61.66	$162.18
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $147.91 / $323.59	Professional	TC	$85.11	$147.91	$323.59
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $234.42 / $363.08	Professional		$77.62	$234.42	$363.08
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $61.66 / $61.66	Facility	26	$46.77	$61.66	$61.66
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $173.78 / $288.40	Professional		$63.10	$173.78	$288.40
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $47.86 / $61.66	Professional	26	$45.71	$47.86	$61.66
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $85.11 / $229.09	Professional	TC	$81.28	$85.11	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $199.53 / $338.84	Professional		$131.83	$199.53	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $53.70 / $89.13	Professional	26	$41.69	$53.70	$89.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $128.82 / $251.19	Professional	TC	$87.10	$128.82	$251.19