Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $190.55 / $426.58	Facility	26	$102.33	$190.55	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $478.63 / $2,187.76	Professional		$213.80	$478.63	$2,187.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $186.21 / $524.81	Professional	26	$100.00	$186.21	$524.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $363.08 / $1,023.29	Professional	TC	$245.47	$363.08	$1,023.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $269.15 / $295.12	Professional		$223.87	$269.15	$295.12
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $97.72 / $158.49	Professional	26	$57.54	$97.72	$158.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $302.00 / $302.00	Professional	TC	$302.00	$302.00	$302.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $524.81 / $1,202.26	Professional		$363.08	$524.81	$1,202.26
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $134.90 / $251.19	Professional	26	$112.20	$134.90	$251.19
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $371.54 / $1,096.48	Professional	TC	$251.19	$371.54	$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 $331.13 / $676.08 / $1,318.26	Professional		$331.13	$676.08	$1,318.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $125.89 / $208.93	Professional	26	$75.86	$125.89	$208.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $524.81 / $1,122.02	Professional	TC	$239.88	$524.81	$1,122.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $467.74 / $1,584.89	Professional		$354.81	$467.74	$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 $251.19 / $323.59 / $407.38	Professional	TC	$251.19	$323.59	$407.38
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $549.54 / $1,047.13	Professional		$346.74	$549.54	$1,047.13
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 $239.88 / $446.68 / $870.96	Professional	TC	$239.88	$446.68	$870.96
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $416.87 / $831.76	Professional		$389.05	$416.87	$831.76
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $123.03 / $177.83	Professional	26	$112.20	$123.03	$177.83
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $354.81 / $354.81	Professional	TC	$354.81	$354.81	$354.81
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $165.96 / $416.87	Facility	26	$102.33	$165.96	$416.87
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $524.81 / $1,380.38	Professional		$338.84	$524.81	$1,380.38
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $162.18 / $363.08	Professional	26	$102.33	$162.18	$363.08
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $389.05 / $933.25	Professional	TC	$251.19	$389.05	$933.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $707.95 / $977.24	Professional		$213.80	$707.95	$977.24
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 $165.96 / $323.59 / $478.63	Professional		$165.96	$323.59	$478.63
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $102.33 / $114.82	Professional	26	$97.72	$102.33	$114.82
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $245.47 / $831.76	Professional	TC	$234.42	$245.47	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $512.86 / $1,023.29	Professional		$331.13	$512.86	$1,023.29
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 $234.42 / $346.74 / $870.96	Professional	TC	$234.42	$346.74	$870.96