Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $63.10 / $114.82	Facility	26	$31.62	$63.10	$114.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $120.23 / $416.87	Professional		$91.20	$120.23	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $45.71 / $95.50	Professional	26	$28.84	$45.71	$95.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $79.43 / $147.91	Professional	TC	$61.66	$79.43	$147.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $36.31 / $51.29	Professional	26	$27.54	$36.31	$51.29
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $109.65 / $194.98	Professional		$104.71	$109.65	$194.98
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $34.67 / $66.07	Professional	26	$33.11	$34.67	$66.07
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $74.13 / $134.90	Professional	TC	$70.79	$74.13	$134.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $38.02 / $53.70	Facility	26	$8.13	$38.02	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $131.83 / $208.93	Professional		$81.28	$131.83	$208.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $41.69 / $67.61	Professional	26	$23.99	$41.69	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $91.20 / $151.36	Professional	TC	$58.88	$91.20	$151.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $177.83	Professional		$112.20	$144.54	$177.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $42.66 / $52.48	Professional	26	$32.36	$42.66	$52.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $100.00 / $125.89	Professional	TC	$79.43	$100.00	$125.89
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $117.49 / $218.78	Professional		$91.20	$117.49	$218.78
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $37.15 / $69.18	Professional	26	$31.62	$37.15	$69.18
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $79.43 / $151.36	Professional	TC	$56.23	$79.43	$151.36
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $131.83 / $138.04	Professional		$125.89	$131.83	$138.04
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $37.15 / $48.98	Professional	26	$33.88	$37.15	$48.98
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $61.66 / $114.82	Facility	26	$31.62	$61.66	$114.82
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $269.15	Professional		$93.33	$128.82	$269.15
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $42.66 / $87.10	Professional	26	$28.18	$42.66	$87.10
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $87.10 / $173.78	Professional	TC	$63.10	$87.10	$173.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $128.82 / $204.17	Professional		$58.88	$128.82	$204.17
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $33.11 / $38.90	Facility	26	$33.11	$33.11	$38.90
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $63.10 / $165.96	Professional		$13.80	$63.10	$165.96
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $33.11 / $38.90	Professional	26	$32.36	$33.11	$38.90
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $74.13 / $83.18	Professional	TC	$74.13	$74.13	$83.18
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $112.20 / $186.21	Professional		$89.13	$112.20	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $37.15 / $63.10	Professional	26	$28.18	$37.15	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $75.86 / $128.82	Professional	TC	$58.88	$75.86	$128.82