Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $245.47 / $501.19	Facility	26	$114.82	$245.47	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $478.63 / $1,659.59	Professional		$309.03	$478.63	$1,659.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $125.89 / $218.78	Professional	26	$81.28	$125.89	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $338.84 / $691.83	Professional	TC	$229.09	$338.84	$691.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $77.62 / $85.11	Professional	26	$64.57	$77.62	$85.11
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $309.03 / $831.76	Professional		$295.12	$309.03	$831.76
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $85.11 / $165.96	Professional	26	$81.28	$85.11	$165.96
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $223.87 / $724.44	Professional	TC	$213.80	$223.87	$724.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $93.33 / $131.83	Facility	26	$19.95	$93.33	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $588.84 / $1,000.00	Professional		$302.00	$588.84	$1,000.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $102.33 / $169.82	Professional	26	$61.66	$102.33	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $436.52 / $831.76	Professional	TC	$223.87	$436.52	$831.76
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $407.38 / $512.86	Professional		$316.23	$407.38	$512.86
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $104.71 / $128.82	Professional	26	$79.43	$104.71	$128.82
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $302.00 / $380.19	Professional	TC	$239.88	$302.00	$380.19
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $436.52 / $870.96	Professional		$309.03	$436.52	$870.96
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $97.72 / $173.78	Professional	26	$69.18	$97.72	$173.78
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $346.74 / $645.65	Professional	TC	$223.87	$346.74	$645.65
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Professional		$346.74	$346.74	$346.74
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $93.33 / $125.89	Professional	26	$85.11	$93.33	$125.89
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $234.42 / $467.74	Facility	26	$114.82	$234.42	$467.74
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $524.81 / $1,071.52	Professional		$316.23	$524.81	$1,071.52
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $125.89 / $257.04	Professional	26	$83.18	$125.89	$257.04
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $371.54 / $776.25	Professional	TC	$229.09	$371.54	$776.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $707.95 / $870.96	Professional		$173.78	$707.95	$870.96
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $91.20 / $91.20	Facility	26	$81.28	$91.20	$91.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $512.86 / $1,174.90	Professional		$302.00	$512.86	$1,174.90
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $83.18 / $91.20	Professional	26	$79.43	$83.18	$91.20
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $229.09 / $501.19	Professional	TC	$218.78	$229.09	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $446.68 / $776.25	Professional		$302.00	$446.68	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $89.13 / $158.49	Professional	26	$70.79	$89.13	$158.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $323.59 / $630.96	Professional	TC	$218.78	$323.59	$630.96