Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $112.20 / $223.87	Facility	26	$57.54	$112.20	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $354.81 / $1,348.96	Professional		$229.09	$354.81	$1,348.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $107.15 / $229.09	Professional	26	$57.54	$107.15	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $234.42 / $524.81	Professional	TC	$162.18	$234.42	$524.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $199.53 / $338.84	Professional		$154.88	$199.53	$338.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $85.11 / $100.00	Professional	26	$47.86	$85.11	$100.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Professional		$371.54	$371.54	$371.54
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $77.62 / $147.91	Professional	26	$60.26	$77.62	$147.91
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $263.03 / $575.44	Professional	TC	$165.96	$263.03	$575.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $69.18 / $97.72	Facility	26	$14.79	$69.18	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $354.81 / $588.84	Professional		$204.17	$354.81	$588.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $75.86 / $125.89	Professional	26	$45.71	$75.86	$125.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $263.03 / $457.09	Professional	TC	$151.36	$263.03	$457.09
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $316.23 / $389.05	Professional		$245.47	$316.23	$389.05
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $77.62 / $95.50	Professional	26	$58.88	$77.62	$95.50
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $234.42 / $295.12	Professional	TC	$186.21	$234.42	$295.12
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $302.00 / $562.34	Professional		$234.42	$302.00	$562.34
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $128.82	Professional	26	$51.29	$72.44	$128.82
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $223.87 / $436.52	Professional	TC	$173.78	$223.87	$436.52
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $288.40 / $309.03	Professional		$269.15	$288.40	$309.03
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $72.44 / $93.33	Professional	26	$64.57	$72.44	$93.33
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $263.03 / $316.23	Professional	TC	$263.03	$263.03	$316.23
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $104.71 / $213.80	Facility	26	$57.54	$104.71	$213.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $346.74 / $724.44	Professional		$229.09	$346.74	$724.44
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $89.13 / $190.55	Professional	26	$57.54	$89.13	$190.55
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $257.04 / $478.63	Professional	TC	$169.82	$257.04	$478.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $323.59 / $457.09	Professional		$100.00	$323.59	$457.09
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $67.61 / $67.61	Facility	26	$60.26	$67.61	$67.61
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $223.87 / $354.81	Professional		$204.17	$223.87	$354.81
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $60.26 / $67.61	Professional	26	$57.54	$60.26	$67.61
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $169.82 / $263.03	Professional	TC	$165.96	$169.82	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $288.40 / $467.74	Professional		$213.80	$288.40	$467.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $66.07 / $107.15	Professional	26	$50.12	$66.07	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $218.78 / $363.08	Professional	TC	$154.88	$218.78	$363.08