Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $186.21 / $380.19	Facility	26	$100.00	$186.21	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $512.86 / $2,344.23	Professional		$309.03	$512.86	$2,344.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $141.25 / $354.81	Professional	26	$95.50	$141.25	$354.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $354.81 / $691.83	Professional	TC	$223.87	$354.81	$691.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $309.03 / $354.81	Professional		$302.00	$309.03	$354.81
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $107.15 / $162.18	Professional	26	$81.28	$107.15	$162.18
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $257.04 / $416.87	Professional	TC	$257.04	$257.04	$416.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $478.63 / $912.01	Professional		$371.54	$478.63	$912.01
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $134.90 / $208.93	Professional	26	$104.71	$134.90	$208.93
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $338.84 / $851.14	Professional	TC	$269.15	$338.84	$851.14
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $117.49 / $169.82	Facility	26	$25.70	$117.49	$169.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $588.84 / $1,023.29	Professional		$331.13	$588.84	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $125.89 / $213.80	Professional	26	$74.13	$125.89	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $457.09 / $794.33	Professional	TC	$239.88	$457.09	$794.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $512.86 / $645.65	Professional		$398.11	$512.86	$645.65
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $134.90 / $165.96	Professional	26	$102.33	$134.90	$165.96
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $380.19 / $478.63	Professional	TC	$295.12	$380.19	$478.63
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $524.81 / $977.24	Professional		$389.05	$524.81	$977.24
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $114.82 / $218.78	Professional	26	$83.18	$114.82	$218.78
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $380.19 / $724.44	Professional	TC	$281.84	$380.19	$724.44
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $478.63 / $512.86	Professional		$436.52	$478.63	$512.86
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $125.89 / $177.83	Professional	26	$114.82	$125.89	$177.83
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $173.78 / $363.08	Facility	26	$100.00	$173.78	$363.08
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $537.03 / $1,096.48	Professional		$363.08	$537.03	$1,096.48
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $138.04 / $309.03	Professional	26	$93.33	$138.04	$309.03
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $398.11 / $724.44	Professional	TC	$269.15	$398.11	$724.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $602.56 / $1,023.29	Professional		$114.82	$602.56	$1,023.29
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $102.33	Facility	26	$95.50	$95.50	$102.33
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $478.63 / $691.83	Professional		$316.23	$478.63	$691.83
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $102.33 / $107.15	Professional	26	$95.50	$102.33	$107.15
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $281.84 / $389.05	Professional	TC	$269.15	$281.84	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $489.78 / $776.25	Professional		$346.74	$489.78	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $114.82 / $181.97	Professional	26	$89.13	$114.82	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $363.08 / $602.56	Professional	TC	$251.19	$363.08	$602.56