Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $239.88 / $467.74	Facility	26	$102.33	$239.88	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $478.63 / $1,778.28	Professional		$275.42	$478.63	$1,778.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $147.91 / $426.58	Professional	26	$85.11	$147.91	$426.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $331.13 / $691.83	Professional	TC	$190.55	$331.13	$691.83
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $75.86 / $75.86	Professional	26	$75.86	$75.86	$75.86
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $275.42 / $676.08	Professional		$263.03	$275.42	$676.08
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $87.10 / $173.78	Professional	26	$85.11	$87.10	$173.78
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $186.21 / $537.03	Professional	TC	$181.97	$186.21	$537.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $512.86 / $912.01	Professional		$257.04	$512.86	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $104.71 / $173.78	Professional	26	$64.57	$104.71	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $380.19 / $776.25	Professional	TC	$177.83	$380.19	$776.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $363.08 / $457.09	Professional		$281.84	$363.08	$457.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $109.65 / $134.90	Professional	26	$83.18	$109.65	$134.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $257.04 / $323.59	Professional	TC	$199.53	$257.04	$323.59
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $436.52 / $812.83	Professional		$275.42	$436.52	$812.83
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $100.00 / $181.97	Professional	26	$72.44	$100.00	$181.97
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $338.84 / $602.56	Professional	TC	$190.55	$338.84	$602.56
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $316.23 / $562.34	Professional		$316.23	$316.23	$562.34
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $107.15 / $741.31	Professional	26	$93.33	$107.15	$741.31
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $223.87 / $426.58	Facility	26	$102.33	$223.87	$426.58
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $478.63 / $1,071.52	Professional		$281.84	$478.63	$1,071.52
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $141.25 / $281.84	Professional	26	$85.11	$141.25	$281.84
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $338.84 / $741.31	Professional	TC	$194.98	$338.84	$741.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $478.63 / $707.95	Professional		$138.04	$478.63	$707.95
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $83.18 / $97.72	Facility	26	$83.18	$83.18	$97.72
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $380.19 / $389.05	Professional		$117.49	$380.19	$389.05
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $83.18 / $97.72	Professional	26	$81.28	$83.18	$97.72
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $186.21 / $512.86	Professional	TC	$181.97	$186.21	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $398.11 / $724.44	Professional		$263.03	$398.11	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $93.33 / $162.18	Professional	26	$72.44	$93.33	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $269.15 / $588.84	Professional	TC	$186.21	$269.15	$588.84