Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $69.18 / $104.71	Facility	26	$25.70	$69.18	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $120.23 / $269.15	Professional		$83.18	$120.23	$269.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $26.92 / $83.18	Professional	26	$20.89	$26.92	$83.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $95.50 / $208.93	Professional	TC	$69.18	$95.50	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $89.13 / $89.13	Professional		$75.86	$89.13	$89.13
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $28.18 / $43.65	Professional	26	$24.55	$28.18	$43.65
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $128.82 / $223.87	Professional		$125.89	$128.82	$223.87
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $27.54 / $63.10	Professional	26	$26.92	$27.54	$63.10
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $102.33 / $165.96	Professional	TC	$97.72	$102.33	$165.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.46 / $30.20 / $43.65	Facility	26	$6.46	$30.20	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $134.90 / $245.47	Professional		$89.13	$134.90	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $33.11 / $53.70	Professional	26	$20.42	$33.11	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $102.33 / $194.98	Professional	TC	$69.18	$102.33	$194.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $181.97 / $229.09	Professional		$141.25	$181.97	$229.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $35.48 / $43.65	Professional	26	$26.92	$35.48	$43.65
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $147.91 / $186.21	Professional	TC	$114.82	$147.91	$186.21
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $141.25 / $275.42	Professional		$83.18	$141.25	$275.42
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $31.62 / $57.54	Professional	26	$21.88	$31.62	$57.54
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $112.20 / $218.78	Professional	TC	$58.88	$112.20	$218.78
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $29.51 / $30.90	Professional	26	$28.84	$29.51	$30.90
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $58.88 / $97.72	Facility	26	$25.70	$58.88	$97.72
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $144.54 / $309.03	Professional		$97.72	$144.54	$309.03
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $33.88 / $74.13	Professional	26	$21.88	$33.88	$74.13
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $112.20 / $239.88	Professional	TC	$74.13	$112.20	$239.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $144.54 / $257.04	Professional		$58.88	$144.54	$257.04
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $26.30 / $28.84	Facility	26	$26.30	$26.30	$28.84
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $70.79 / $158.49	Professional		$25.70	$70.79	$158.49
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $26.30 / $28.84	Professional	26	$25.70	$26.30	$28.84
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $100.00 / $109.65	Professional	TC	$81.28	$100.00	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $123.03 / $204.17	Professional		$91.20	$123.03	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $28.18 / $48.98	Professional	26	$21.38	$28.18	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $93.33 / $162.18	Professional	TC	$69.18	$93.33	$162.18