Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $17.38 / $38.02	Facility	26	$8.13	$17.38	$38.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $42.66 / $144.54	Professional		$23.99	$42.66	$144.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $13.80 / $35.48	Professional	26	$7.59	$13.80	$35.48
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $53.70 / $158.49	Professional	52	$30.20	$53.70	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $26.30 / $81.28	Professional	TC	$15.14	$26.30	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $20.42 / $20.42	Professional		$20.42	$20.42	$20.42
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.47 / $18.20	Professional	26	$7.94	$10.47	$18.20
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $41.69 / $63.10	Professional		$28.18	$41.69	$63.10
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.30 / $23.44	Professional	26	$9.12	$12.30	$23.44
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $28.84 / $43.65	Professional	TC	$19.05	$28.84	$43.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.19 / $10.23 / $14.79	Facility	26	$2.19	$10.23	$14.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $41.69 / $67.61	Professional		$24.55	$41.69	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $12.30 / $20.42	Professional	26	$7.41	$12.30	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $29.51 / $46.77	Professional	TC	$17.78	$29.51	$46.77
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $41.69 / $51.29	Professional		$32.36	$41.69	$51.29
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $12.59 / $15.49	Professional	26	$9.55	$12.59	$15.49
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $28.84 / $36.31	Professional	TC	$22.91	$28.84	$36.31
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $37.15 / $74.13	Professional		$27.54	$37.15	$74.13
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $11.48 / $21.38	Professional	26	$8.13	$11.48	$21.38
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $25.70 / $53.70	Professional	TC	$19.05	$25.70	$53.70
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $35.48 / $37.15	Professional		$30.20	$35.48	$37.15
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $10.00 / $14.79	Professional	26	$10.00	$10.00	$14.79
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $5.01 / $5.01 / $5.01	Professional	52	$5.01	$5.01	$5.01
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $16.22 / $38.02	Facility	26	$8.51	$16.22	$38.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $42.66 / $89.13	Professional		$23.99	$42.66	$89.13
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $12.88 / $26.92	Professional	26	$7.94	$12.88	$26.92
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $33.88 / $93.33	Professional	52	$30.20	$33.88	$93.33
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $28.84 / $57.54	Professional	TC	$15.85	$28.84	$57.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $47.86 / $77.62	Professional		$19.05	$47.86	$77.62
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $10.96 / $10.96	Facility	26	$8.91	$10.96	$10.96
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $23.44 / $38.90	Professional		$12.02	$23.44	$38.90
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.12 / $10.96	Professional	26	$8.71	$9.12	$10.96
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $19.05 / $25.70	Professional	TC	$18.20	$19.05	$25.70
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $34.67 / $56.23	Professional		$26.92	$34.67	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.23 / $17.78	Professional	26	$7.94	$10.23	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $23.99 / $38.90	Professional	TC	$18.62	$23.99	$38.90