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 $208.93 / $467.74 / $1,412.54	Professional		$208.93	$467.74	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $141.25 / $316.23	Professional	26	$69.18	$141.25	$316.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $245.47 / $645.65	Professional	TC	$123.03	$245.47	$645.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $134.90 / $257.04	Professional		$63.10	$134.90	$257.04
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 / $154.88	Professional	TC	$93.33	$112.20	$154.88
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $295.12 / $645.65	Professional		$199.53	$295.12	$645.65
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $95.50 / $181.97	Professional	26	$74.13	$95.50	$181.97
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $186.21 / $707.95	Professional	TC	$125.89	$186.21	$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 / $776.25	Professional		$186.21	$398.11	$776.25
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 / $645.65	Professional	TC	$114.82	$295.12	$645.65
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 / $208.93	Professional	TC	$131.83	$165.96	$208.93
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $371.54 / $660.69	Professional		$194.98	$371.54	$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 $123.03 / $251.19 / $512.86	Professional	TC	$123.03	$251.19	$512.86
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $223.87 / $380.19	Professional		$208.93	$223.87	$380.19
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $85.11 / $123.03	Professional	26	$74.13	$85.11	$123.03
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $218.78 / $223.87	Professional	TC	$186.21	$218.78	$223.87
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 $213.80 / $426.58 / $977.24	Professional		$213.80	$426.58	$977.24
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $125.89 / $263.03	Professional	26	$70.79	$125.89	$263.03
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $263.03 / $616.60	Professional	TC	$131.83	$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 / $69.18 / $87.10	Facility	26	$69.18	$69.18	$87.10
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $323.59 / $354.81	Professional		$75.86	$323.59	$354.81
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $69.18 / $72.44	Professional	26	$67.61	$69.18	$72.44
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $120.23 / $134.90	Professional	TC	$117.49	$120.23	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $281.84 / $602.56	Professional		$186.21	$281.84	$602.56
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 / $489.78	Professional	TC	$120.23	$173.78	$489.78