Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $138.04 / $416.87	Facility	26	$64.57	$138.04	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $426.58 / $1,698.24	Professional		$154.88	$426.58	$1,698.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $138.04 / $363.08	Professional	26	$64.57	$138.04	$363.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $707.95 / $724.44 / $3,801.89	Professional	50	$707.95	$724.44	$3,801.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $331.13 / $707.95	Professional	TC	$173.78	$331.13	$707.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $169.82 / $218.78	Professional		$158.49	$169.82	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $61.66 / $120.23	Professional	26	$51.29	$61.66	$120.23
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $190.55 / $208.93	Professional	TC	$123.03	$190.55	$208.93
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $380.19 / $812.83	Professional		$239.88	$380.19	$812.83
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $85.11 / $158.49	Professional	26	$69.18	$85.11	$158.49
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $478.63 / $758.58 / $1,621.81	Professional	50	$478.63	$758.58	$1,621.81
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $269.15 / $707.95	Professional	TC	$169.82	$269.15	$707.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $72.44 / $104.71	Facility	26	$15.49	$72.44	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $446.68 / $794.33	Professional		$229.09	$446.68	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $79.43 / $131.83	Professional	26	$47.86	$79.43	$131.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $338.84 / $691.83	Professional	TC	$162.18	$338.84	$691.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $309.03 / $1,071.52	Professional		$234.42	$309.03	$1,071.52
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $83.18 / $102.33	Professional	26	$63.10	$83.18	$102.33
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $218.78 / $275.42	Professional	TC	$173.78	$218.78	$275.42
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $354.81 / $660.69	Professional		$229.09	$354.81	$660.69
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $75.86 / $138.04	Professional	26	$54.95	$75.86	$138.04
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $288.40 / $537.03	Professional	TC	$162.18	$288.40	$537.03
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $263.03 / $512.86	Professional		$245.47	$263.03	$512.86
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $74.13 / $100.00	Professional	26	$70.79	$74.13	$100.00
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $288.40 / $302.00	Professional	TC	$239.88	$288.40	$302.00
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $125.89 / $416.87	Facility	26	$64.57	$125.89	$416.87
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $446.68 / $1,071.52	Professional		$229.09	$446.68	$1,071.52
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $123.03 / $281.84	Professional	26	$66.07	$123.03	$281.84
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $707.95 / $1,023.29 / $3,801.89	Professional	50	$707.95	$1,023.29	$3,801.89
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $323.59 / $660.69	Professional	TC	$181.97	$323.59	$660.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $575.44 / $707.95	Professional		$138.04	$575.44	$707.95
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $89.13	Facility	26	$63.10	$63.10	$89.13
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $269.15 / $338.84	Professional		$100.00	$269.15	$338.84
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $63.10 / $89.13	Professional	26	$61.66	$63.10	$89.13
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $162.18 / $416.87	Professional	TC	$158.49	$162.18	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $331.13 / $602.56	Professional		$218.78	$331.13	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $69.18 / $123.03	Professional	26	$54.95	$69.18	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $234.42 / $501.19	Professional	TC	$158.49	$234.42	$501.19