Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $138.04 / $416.87	Facility	26	$70.79	$138.04	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $478.63 / $1,412.54	Professional		$199.53	$478.63	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $128.82 / $281.84	Professional	26	$69.18	$128.82	$281.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $158.49 / $524.81 / $870.96	Professional	52	$158.49	$524.81	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $234.42 / $776.25	Professional	TC	$117.49	$234.42	$776.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $154.88 / $229.09	Professional		$131.83	$154.88	$229.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $72.44 / $114.82	Professional	26	$56.23	$72.44	$114.82
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $112.20 / $181.97	Professional	TC	$93.33	$112.20	$181.97
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $331.13 / $588.84	Professional		$223.87	$331.13	$588.84
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $97.72 / $181.97	Professional	26	$83.18	$97.72	$181.97
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $213.80 / $707.95	Professional	TC	$141.25	$213.80	$707.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $114.82	Facility	26	$16.98	$79.43	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $398.11 / $741.31	Professional		$186.21	$398.11	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $91.20 / $154.88	Professional	26	$52.48	$91.20	$154.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $295.12 / $616.60	Professional	TC	$114.82	$295.12	$616.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $263.03 / $1,000.00	Professional		$199.53	$263.03	$1,000.00
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $91.20 / $112.20	Professional	26	$69.18	$91.20	$112.20
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $165.96 / $213.80	Professional	TC	$131.83	$165.96	$213.80
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $363.08 / $660.69	Professional		$177.83	$363.08	$660.69
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $87.10 / $158.49	Professional	26	$64.57	$87.10	$158.49
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $251.19 / $512.86	Professional	TC	$112.20	$251.19	$512.86
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $218.78 / $389.05	Professional		$208.93	$218.78	$389.05
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $85.11 / $120.23	Professional	26	$75.86	$85.11	$120.23
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $40.74 / $42.66 / $120.23	Professional	52	$40.74	$42.66	$120.23
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $223.87 / $446.68	Professional	TC	$186.21	$223.87	$446.68
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $263.03 / $467.74	Professional		$218.78	$263.03	$467.74
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $87.10 / $114.82	Professional	26	$79.43	$87.10	$114.82
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $131.83 / $416.87	Facility	26	$70.79	$131.83	$416.87
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $426.58 / $1,023.29	Professional		$208.93	$426.58	$1,023.29
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $125.89 / $257.04	Professional	26	$70.79	$125.89	$257.04
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $158.49 / $512.86 / $1,698.24	Professional	52	$158.49	$512.86	$1,698.24
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $263.03 / $616.60	Professional	TC	$128.82	$263.03	$616.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $338.84 / $707.95	Professional		$112.20	$338.84	$707.95
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $83.18 / $83.18	Facility	26	$69.18	$83.18	$83.18
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $323.59 / $407.38	Professional		$102.33	$323.59	$407.38
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $70.79 / $83.18	Professional	26	$67.61	$70.79	$83.18
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $123.03 / $416.87	Professional	TC	$117.49	$123.03	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $281.84 / $575.44	Professional		$186.21	$281.84	$575.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $77.62 / $134.90	Professional	26	$61.66	$77.62	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $173.78 / $457.09	Professional	TC	$120.23	$173.78	$457.09