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 $67.61 / $89.13 / $257.04	Professional		$67.61	$89.13	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $48.98 / $114.82	Professional	26	$28.84	$48.98	$114.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $51.29 / $93.33	Professional	TC	$39.81	$51.29	$93.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $31.62 / $47.86	Professional	26	$29.51	$31.62	$47.86
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $83.18 / $147.91	Professional		$79.43	$83.18	$147.91
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 $45.71 / $47.86 / $87.10	Professional	TC	$45.71	$47.86	$87.10
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 $61.66 / $100.00 / $158.49	Professional		$61.66	$100.00	$158.49
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 $38.02 / $57.54 / $95.50	Professional	TC	$38.02	$57.54	$95.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $107.15 / $134.90	Professional		$83.18	$107.15	$134.90
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 $51.29 / $64.57 / $81.28	Professional	TC	$51.29	$64.57	$81.28
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $89.13 / $165.96	Professional		$70.79	$89.13	$165.96
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 $36.31 / $51.29 / $95.50	Professional	TC	$36.31	$51.29	$95.50
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $37.15 / $50.12	Professional	26	$36.31	$37.15	$50.12
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 $70.79 / $97.72 / $208.93	Professional		$70.79	$97.72	$208.93
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $43.65 / $95.50	Professional	26	$28.18	$43.65	$95.50
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $57.54 / $114.82	Professional	TC	$40.74	$57.54	$114.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $144.54 / $181.97	Professional		$120.23	$144.54	$181.97
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 $9.12 / $47.86 / $87.10	Professional		$9.12	$47.86	$87.10
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $33.11 / $33.88	Professional	26	$32.36	$33.11	$33.88
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $47.86 / $52.48	Professional	TC	$46.77	$47.86	$52.48
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $85.11 / $141.25	Professional		$66.07	$85.11	$141.25
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 $38.02 / $48.98 / $83.18	Professional	TC	$38.02	$48.98	$83.18