Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $89.13 / $173.78	Facility	26	$45.71	$89.13	$173.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $173.78 / $616.60	Professional		$60.26	$173.78	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $81.28 / $194.98	Professional	26	$45.71	$81.28	$194.98
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	50	$43.65	$43.65	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $169.82 / $426.58	Professional	TC	$102.33	$169.82	$426.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $141.25 / $190.55	Professional		$114.82	$141.25	$190.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $50.12 / $79.43	Professional	26	$37.15	$50.12	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $147.91 / $162.18	Professional	TC	$134.90	$147.91	$162.18
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $158.49 / $407.38	Professional		$151.36	$158.49	$407.38
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $63.10 / $123.03	Professional	26	$46.77	$63.10	$123.03
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $302.00 / $316.23 / $812.83	Professional	50	$302.00	$316.23	$812.83
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $109.65 / $316.23	Professional	TC	$104.71	$109.65	$316.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $53.70 / $75.86	Facility	26	$11.48	$53.70	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $257.04 / $436.52	Professional		$147.91	$257.04	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $61.66 / $102.33	Professional	26	$35.48	$61.66	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $186.21 / $331.13	Professional	TC	$104.71	$186.21	$331.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $208.93 / $263.03	Professional		$162.18	$208.93	$263.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $61.66 / $75.86	Professional	26	$46.77	$61.66	$75.86
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 $158.49 / $213.80 / $416.87	Professional		$158.49	$213.80	$416.87
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $60.26 / $109.65	Professional	26	$43.65	$60.26	$109.65
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $151.36 / $309.03	Professional	TC	$107.15	$151.36	$309.03
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $199.53 / $213.80	Professional		$186.21	$199.53	$213.80
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $56.23 / $81.28	Professional	26	$52.48	$56.23	$81.28
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $208.93 / $208.93	Professional	TC	$208.93	$208.93	$208.93
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $81.28 / $165.96	Facility	26	$45.71	$81.28	$165.96
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $218.78 / $524.81	Professional		$109.65	$218.78	$524.81
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $70.79 / $154.88	Professional	26	$45.71	$70.79	$154.88
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $43.65 / $354.81	Professional	50	$43.65	$43.65	$354.81
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $173.78 / $331.13	Professional	TC	$104.71	$173.78	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $316.23 / $354.81	Professional		$102.33	$316.23	$354.81
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $46.77 / $57.54	Facility	26	$46.77	$46.77	$57.54
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $158.49 / $302.00	Professional		$70.79	$158.49	$302.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $46.77 / $57.54	Professional	26	$45.71	$46.77	$57.54
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $102.33 / $190.55	Professional	TC	$97.72	$102.33	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $208.93 / $338.84	Professional		$154.88	$208.93	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $52.48 / $85.11	Professional	26	$40.74	$52.48	$85.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $151.36 / $257.04	Professional	TC	$109.65	$151.36	$257.04