Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $72.44 / $109.65	Facility	26	$30.90	$72.44	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $120.23 / $338.84	Professional		$89.13	$120.23	$338.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.18 / $89.13	Professional	26	$21.88	$28.18	$89.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $91.20 / $204.17	Professional	TC	$66.07	$91.20	$204.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $30.20 / $30.20	Professional	26	$30.20	$30.20	$30.20
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $125.89 / $218.78	Professional		$120.23	$125.89	$218.78
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $28.84 / $53.70	Professional	26	$27.54	$28.84	$53.70
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $95.50 / $165.96	Professional	TC	$93.33	$95.50	$165.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	26	$6.76	$31.62	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $131.83 / $245.47	Professional		$89.13	$131.83	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $33.88 / $56.23	Professional	26	$20.89	$33.88	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $97.72 / $190.55	Professional	TC	$66.07	$97.72	$190.55
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 $29.51 / $38.02 / $46.77	Professional	26	$29.51	$38.02	$46.77
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $144.54 / $181.97	Professional	TC	$112.20	$144.54	$181.97
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $138.04 / $275.42	Professional		$83.18	$138.04	$275.42
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $33.11 / $61.66	Professional	26	$21.88	$33.11	$61.66
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $104.71 / $213.80	Professional	TC	$57.54	$104.71	$213.80
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $30.20 / $30.90	Professional	26	$30.20	$30.20	$30.90
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $72.44 / $104.71	Facility	26	$30.90	$72.44	$104.71
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $138.04 / $323.59	Professional		$100.00	$138.04	$323.59
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $33.11 / $77.62	Professional	26	$22.91	$33.11	$77.62
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $107.15 / $239.88	Professional	TC	$74.13	$107.15	$239.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $144.54 / $257.04	Professional		$63.10	$144.54	$257.04
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $28.84 / $28.84	Facility	26	$27.54	$28.84	$28.84
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $77.62 / $154.88	Professional		$46.77	$77.62	$154.88
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $28.18 / $28.84	Professional	26	$26.92	$28.18	$28.84
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $97.72 / $107.15	Professional	TC	$81.28	$97.72	$107.15
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 $22.91 / $30.20 / $52.48	Professional	26	$22.91	$30.20	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $93.33 / $158.49	Professional	TC	$66.07	$93.33	$158.49