Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $114.82 / $208.93	Facility	26	$57.54	$114.82	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $234.42 / $851.14	Professional		$138.04	$234.42	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $95.50 / $208.93	Professional	26	$53.70	$95.50	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $128.82 / $338.84	Professional	TC	$81.28	$128.82	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $109.65 / $204.17	Professional		$97.72	$109.65	$204.17
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $53.70 / $100.00	Professional	26	$45.71	$53.70	$100.00
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $102.33 / $102.33	Professional	TC	$102.33	$102.33	$102.33
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $72.44 / $138.04	Professional	26	$56.23	$72.44	$138.04
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $134.90 / $398.11	Professional	TC	$79.43	$134.90	$398.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $64.57 / $91.20	Facility	26	$13.80	$64.57	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $245.47 / $436.52	Professional		$125.89	$245.47	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $69.18 / $117.49	Professional	26	$42.66	$69.18	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $154.88 / $302.00	Professional	TC	$74.13	$154.88	$302.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $186.21 / $229.09	Professional		$144.54	$186.21	$229.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $72.44 / $89.13	Professional	26	$56.23	$72.44	$89.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $112.20 / $141.25	Professional	TC	$87.10	$112.20	$141.25
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $213.80 / $380.19	Professional		$141.25	$213.80	$380.19
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $69.18 / $123.03	Professional	26	$47.86	$69.18	$123.03
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $154.88 / $257.04	Professional	TC	$83.18	$154.88	$257.04
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $173.78 / $181.97	Professional		$158.49	$173.78	$181.97
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $66.07 / $87.10	Professional	26	$63.10	$66.07	$87.10
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $147.91 / $147.91	Professional	TC	$147.91	$147.91	$147.91
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $104.71 / $204.17	Facility	26	$57.54	$104.71	$204.17
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $234.42 / $512.86	Professional		$141.25	$234.42	$512.86
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $81.28 / $177.83	Professional	26	$54.95	$81.28	$177.83
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $141.25 / $316.23	Professional	TC	$83.18	$141.25	$316.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $239.88 / $323.59	Professional		$74.13	$239.88	$323.59
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $64.57 / $64.57	Facility	26	$56.23	$64.57	$64.57
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $117.49 / $173.78	Professional		$41.69	$117.49	$173.78
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $56.23 / $64.57	Professional	26	$54.95	$56.23	$64.57
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $81.28 / $218.78	Professional	TC	$79.43	$81.28	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $190.55 / $323.59	Professional		$128.82	$190.55	$323.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $61.66 / $100.00	Professional	26	$47.86	$61.66	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $109.65 / $234.42	Professional	TC	$75.86	$109.65	$234.42