Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $281.84 / $501.19	Facility	26	$123.03	$281.84	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $501.19 / $1,348.96	Professional		$346.74	$501.19	$1,348.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $131.83 / $275.42	Professional	26	$85.11	$131.83	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $338.84 / $691.83	Professional	TC	$257.04	$338.84	$691.83
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $870.96	Professional		$331.13	$478.63	$870.96
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $109.65 / $213.80	Professional	26	$85.11	$109.65	$213.80
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $660.69 / $954.99 / $1,737.80	Professional	50	$660.69	$954.99	$1,737.80
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $363.08 / $707.95	Professional	TC	$245.47	$363.08	$707.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $97.72 / $138.04	Facility	26	$20.89	$97.72	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $562.34 / $954.99	Professional		$309.03	$562.34	$954.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $107.15 / $177.83	Professional	26	$64.57	$107.15	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $446.68 / $758.58	Professional	TC	$239.88	$446.68	$758.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $457.09 / $575.44	Professional		$354.81	$457.09	$575.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $109.65 / $134.90	Professional	26	$85.11	$109.65	$134.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $346.74 / $436.52	Professional	TC	$275.42	$346.74	$436.52
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $467.74 / $912.01	Professional		$346.74	$467.74	$912.01
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $102.33 / $181.97	Professional	26	$74.13	$102.33	$181.97
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $346.74 / $691.83	Professional	TC	$257.04	$346.74	$691.83
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $112.20 / $724.44	Professional	26	$97.72	$112.20	$724.44
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $229.09 / $426.58	Facility	26	$123.03	$229.09	$426.58
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $524.81 / $1,122.02	Professional		$346.74	$524.81	$1,122.02
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $128.82 / $269.15	Professional	26	$85.11	$128.82	$269.15
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $380.19 / $794.33	Professional	TC	$257.04	$380.19	$794.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $676.08 / $831.76	Professional		$181.97	$676.08	$831.76
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $91.20 / $91.20	Facility	26	$85.11	$91.20	$91.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $331.13 / $416.87	Professional		$64.57	$331.13	$416.87
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $85.11 / $91.20	Professional	26	$81.28	$85.11	$91.20
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $251.19 / $416.87	Professional	TC	$245.47	$251.19	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $446.68 / $741.31	Professional		$316.23	$446.68	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $93.33 / $158.49	Professional	26	$69.18	$93.33	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $354.81 / $602.56	Professional	TC	$234.42	$354.81	$602.56