Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $52.48 / $91.20	Facility	26	$24.55	$52.48	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $89.13 / $407.38	Professional		$48.98	$89.13	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $41.69 / $109.65	Professional	26	$23.44	$41.69	$109.65
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $42.66 / $83.18 / $371.54	Professional	52	$42.66	$83.18	$371.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $47.86 / $134.90	Professional	TC	$25.12	$47.86	$134.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $48.98 / $83.18	Professional		$32.36	$48.98	$83.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $26.30 / $44.67	Professional	26	$10.23	$26.30	$44.67
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $13.49 / $13.49 / $13.49	Professional	52	$13.49	$13.49	$13.49
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $27.54 / $38.02	Professional	TC	$22.39	$27.54	$38.02
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $158.49	Professional		$56.23	$56.23	$158.49
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $32.36 / $63.10	Professional	26	$26.92	$32.36	$63.10
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $38.02 / $107.15	Professional	TC	$29.51	$38.02	$107.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $30.90 / $44.67	Facility	26	$6.61	$30.90	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $89.13 / $151.36	Professional		$53.70	$89.13	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $32.36 / $53.70	Professional	26	$20.89	$32.36	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $57.54 / $100.00	Professional	TC	$28.84	$57.54	$100.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $102.33	Professional		$72.44	$85.11	$102.33
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $37.15 / $45.71	Professional	26	$23.99	$37.15	$45.71
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $45.71 / $57.54	Professional	TC	$29.51	$45.71	$57.54
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $81.28 / $128.82	Professional		$58.88	$81.28	$128.82
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $34.67 / $56.23	Professional	26	$24.55	$34.67	$56.23
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $46.77 / $83.18	Professional	TC	$34.67	$46.77	$83.18
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $70.79 / $75.86	Professional		$64.57	$70.79	$75.86
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $31.62 / $45.71	Professional	26	$15.49	$31.62	$45.71
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $33.11 / $33.11 / $33.11	Professional	52	$33.11	$33.11	$33.11
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $48.98 / $89.13	Facility	26	$24.55	$48.98	$89.13
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $91.20 / $218.78	Professional		$51.29	$91.20	$218.78
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $37.15 / $83.18	Professional	26	$23.44	$37.15	$83.18
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $46.77 / $85.11 / $354.81	Professional	52	$46.77	$85.11	$354.81
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $53.70 / $117.49	Professional	TC	$26.30	$53.70	$117.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $109.65 / $173.78	Professional		$54.95	$109.65	$173.78
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $27.54 / $27.54 / $30.20	Facility	26	$27.54	$27.54	$30.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $48.98 / $85.11	Professional		$21.88	$48.98	$85.11
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $27.54 / $30.20	Professional	26	$26.30	$27.54	$30.20
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $27.54 / $50.12	Professional	TC	$27.54	$27.54	$50.12
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $81.28 / $131.83	Professional		$61.66	$81.28	$131.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $29.51 / $48.98	Professional	26	$21.88	$29.51	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $51.29 / $89.13	Professional	TC	$36.31	$51.29	$89.13