Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $85.11 / $173.78	Facility	26	$45.71	$85.11	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $229.09 / $891.25	Professional		$131.83	$229.09	$891.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $63.10 / $199.53	Professional	26	$43.65	$63.10	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $141.25 / $338.84	Professional	TC	$83.18	$141.25	$338.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $44.67 / $67.61	Professional	26	$30.90	$44.67	$67.61
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $109.65 / $125.89	Professional	TC	$77.62	$109.65	$125.89
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $131.83 / $478.63	Professional		$128.82	$131.83	$478.63
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $63.10 / $123.03	Professional	26	$46.77	$63.10	$123.03
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $83.18 / $371.54	Professional	TC	$81.28	$83.18	$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 / $251.19 / $436.52	Professional		$131.83	$251.19	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $63.10 / $100.00	Professional	26	$35.48	$63.10	$100.00
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 $89.13 / $114.82 / $144.54	Professional	TC	$89.13	$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 $151.36 / $165.96 / $173.78	Professional		$151.36	$165.96	$173.78
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $58.88 / $89.13	Professional	26	$52.48	$58.88	$89.13
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $151.36 / $158.49	Professional	TC	$151.36	$151.36	$158.49
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $70.79 / $165.96	Facility	26	$45.71	$70.79	$165.96
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $234.42 / $512.86	Professional		$134.90	$234.42	$512.86
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $64.57 / $162.18	Professional	26	$44.67	$64.57	$162.18
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $147.91 / $331.13	Professional	TC	$87.10	$147.91	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $234.42 / $354.81	Professional		$75.86	$234.42	$354.81
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 / $181.97 / $288.40	Professional		$63.10	$181.97	$288.40
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $47.86 / $61.66	Professional	26	$46.77	$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 / $194.98 / $338.84	Professional		$131.83	$194.98	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $53.70 / $87.10	Professional	26	$41.69	$53.70	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $128.82 / $251.19	Professional	TC	$87.10	$128.82	$251.19