Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $58.88 / $102.33	Facility	26	$30.20	$58.88	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $125.89 / $512.86	Professional		$67.61	$125.89	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $41.69 / $91.20	Professional	26	$25.70	$41.69	$91.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $89.13 / $269.15	Professional	TC	$46.77	$89.13	$269.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $38.90 / $52.48	Professional	26	$20.42	$38.90	$52.48
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $102.33 / $181.97	Professional		$97.72	$102.33	$181.97
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $35.48 / $60.26	Professional	26	$27.54	$35.48	$60.26
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $74.13 / $128.82	Professional	TC	$70.79	$74.13	$128.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $31.62 / $44.67	Facility	26	$6.76	$31.62	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $120.23 / $229.09	Professional		$75.86	$120.23	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $33.88 / $63.10	Professional	26	$19.95	$33.88	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $85.11 / $162.18	Professional	TC	$54.95	$85.11	$162.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $134.90 / $169.82	Professional		$104.71	$134.90	$169.82
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $35.48 / $43.65	Professional	26	$26.92	$35.48	$43.65
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $100.00 / $125.89	Professional	TC	$77.62	$100.00	$125.89
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $102.33 / $204.17	Professional		$61.66	$102.33	$204.17
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $30.90 / $57.54	Professional	26	$23.44	$30.90	$57.54
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $74.13 / $147.91	Professional	TC	$33.11	$74.13	$147.91
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $128.82 / $134.90	Professional		$120.23	$128.82	$134.90
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $32.36 / $47.86	Professional	26	$28.84	$32.36	$47.86
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $109.65 / $109.65	Professional	TC	$109.65	$109.65	$109.65
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $51.29 / $100.00	Facility	26	$30.20	$51.29	$100.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $128.82 / $331.13	Professional		$72.44	$128.82	$331.13
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $40.74 / $81.28	Professional	26	$25.70	$40.74	$81.28
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $91.20 / $208.93	Professional	TC	$44.67	$91.20	$208.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $117.49 / $208.93	Professional		$58.88	$117.49	$208.93
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $27.54 / $27.54	Facility	26	$26.30	$27.54	$27.54
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $97.72 / $346.74	Professional		$33.11	$97.72	$346.74
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $27.54 / $28.84	Professional	26	$26.92	$27.54	$28.84
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $70.79 / $79.43	Professional	TC	$69.18	$70.79	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $104.71 / $169.82	Professional		$79.43	$104.71	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $29.51 / $48.98	Professional	26	$22.91	$29.51	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $75.86 / $125.89	Professional	TC	$56.23	$75.86	$125.89