Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $138.04 / $199.53	Facility	26	$56.23	$138.04	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $213.80 / $676.08	Professional		$173.78	$213.80	$676.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $52.48 / $169.82	Professional	26	$41.69	$52.48	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $158.49 / $316.23	Professional	TC	$125.89	$158.49	$316.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $74.13 / $85.11	Professional	26	$48.98	$74.13	$85.11
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $204.17 / $426.58	Professional		$194.98	$204.17	$426.58
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $53.70 / $104.71	Professional	26	$52.48	$53.70	$104.71
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $147.91 / $331.13	Professional	TC	$144.54	$147.91	$331.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $58.88 / $85.11	Facility	26	$12.59	$58.88	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $281.84 / $524.81	Professional		$165.96	$281.84	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $64.57 / $109.65	Professional	26	$38.02	$64.57	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $208.93 / $346.74	Professional	TC	$128.82	$208.93	$346.74
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $269.15 / $338.84	Professional		$208.93	$269.15	$338.84
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $66.07 / $81.28	Professional	26	$51.29	$66.07	$81.28
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $199.53 / $257.04	Professional	TC	$158.49	$199.53	$257.04
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $234.42 / $407.38	Professional		$186.21	$234.42	$407.38
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $60.26 / $109.65	Professional	26	$48.98	$60.26	$109.65
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $173.78 / $302.00	Professional	TC	$134.90	$173.78	$302.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $66.07 / $93.33	Professional	26	$58.88	$66.07	$93.33
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $134.90 / $190.55	Facility	26	$56.23	$134.90	$190.55
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $269.15 / $724.44	Professional		$181.97	$269.15	$724.44
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $58.88 / $144.54	Professional	26	$43.65	$58.88	$144.54
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $181.97 / $446.68	Professional	TC	$134.90	$181.97	$446.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $354.81 / $457.09	Professional		$302.00	$354.81	$457.09
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.29 / $61.66	Facility	26	$51.29	$51.29	$61.66
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $199.53 / $223.87	Professional		$56.23	$199.53	$223.87
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $51.29 / $61.66	Professional	26	$50.12	$51.29	$61.66
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $151.36 / $190.55	Professional	TC	$147.91	$151.36	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $234.42 / $398.11	Professional		$190.55	$234.42	$398.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $57.54 / $100.00	Professional	26	$45.71	$57.54	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $181.97 / $309.03	Professional	TC	$141.25	$181.97	$309.03