Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $229.09 / $426.58	Facility	26	$102.33	$229.09	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $512.86 / $2,187.76	Professional		$239.88	$512.86	$2,187.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $177.83 / $478.63	Professional	26	$102.33	$177.83	$478.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $426.58 / $1,023.29	Professional	TC	$295.12	$426.58	$1,023.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $323.59 / $371.54	Professional		$323.59	$323.59	$371.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $95.50 / $158.49	Professional	26	$79.43	$95.50	$158.49
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $588.84 / $1,202.26	Professional		$426.58	$588.84	$1,202.26
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $134.90 / $251.19	Professional	26	$107.15	$134.90	$251.19
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $478.63 / $1,096.48	Professional	TC	$316.23	$478.63	$1,096.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $117.49 / $165.96	Facility	26	$25.12	$117.49	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $758.58 / $1,348.96	Professional		$398.11	$758.58	$1,348.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $125.89 / $208.93	Professional	26	$77.62	$125.89	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $588.84 / $1,122.02	Professional	TC	$302.00	$588.84	$1,122.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $562.34 / $1,584.89	Professional		$426.58	$562.34	$1,584.89
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $131.83 / $162.18	Professional	26	$100.00	$131.83	$162.18
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $416.87 / $524.81	Professional	TC	$331.13	$416.87	$524.81
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $645.65 / $1,122.02	Professional		$416.87	$645.65	$1,122.02
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $123.03 / $218.78	Professional	26	$87.10	$123.03	$218.78
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $478.63 / $933.25	Professional	TC	$309.03	$478.63	$933.25
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $524.81 / $851.14	Professional		$467.74	$524.81	$851.14
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $123.03 / $173.78	Professional	26	$112.20	$123.03	$173.78
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $190.55 / $416.87	Facility	26	$102.33	$190.55	$416.87
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $602.56 / $1,380.38	Professional		$371.54	$602.56	$1,380.38
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $158.49 / $331.13	Professional	26	$102.33	$158.49	$331.13
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $457.09 / $1,000.00	Professional	TC	$302.00	$457.09	$1,000.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $707.95 / $954.99	Professional		$213.80	$707.95	$954.99
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $114.82 / $114.82	Facility	26	$100.00	$114.82	$114.82
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $407.38 / $478.63	Professional		$316.23	$407.38	$478.63
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $102.33 / $114.82	Professional	26	$100.00	$102.33	$114.82
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $316.23 / $831.76	Professional	TC	$302.00	$316.23	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $602.56 / $1,096.48	Professional		$407.38	$602.56	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $109.65 / $194.98	Professional	26	$87.10	$109.65	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $309.03 / $446.68 / $912.01	Professional	TC	$309.03	$446.68	$912.01