Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $46.77 / $91.20	Facility	26	$23.44	$46.77	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $131.83 / $489.78	Professional		$81.28	$131.83	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $35.48 / $89.13	Professional	26	$22.91	$35.48	$89.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $85.11 / $239.88	Professional	TC	$58.88	$85.11	$239.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $89.13 / $102.33	Professional		$70.79	$89.13	$102.33
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $35.48 / $39.81	Professional	26	$20.89	$35.48	$39.81
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $72.44 / $120.23	Professional	TC	$72.44	$72.44	$120.23
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $107.15 / $177.83	Professional		$102.33	$107.15	$177.83
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $26.92 / $50.12	Professional	26	$25.70	$26.92	$50.12
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $79.43 / $134.90	Professional	TC	$77.62	$79.43	$134.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.31 / $29.51 / $41.69	Facility	26	$6.31	$29.51	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $120.23 / $199.53	Professional		$81.28	$120.23	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $33.11 / $52.48	Professional	26	$20.42	$33.11	$52.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $87.10 / $147.91	Professional	TC	$57.54	$87.10	$147.91
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $147.91 / $181.97	Professional		$125.89	$147.91	$181.97
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $34.67 / $42.66	Professional	26	$21.88	$34.67	$42.66
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $109.65 / $138.04	Professional	TC	$70.79	$109.65	$138.04
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $117.49 / $190.55	Professional		$77.62	$117.49	$190.55
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.11 / $47.86	Professional	26	$24.55	$33.11	$47.86
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $83.18 / $138.04	Professional	TC	$50.12	$83.18	$138.04
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $131.83 / $141.25	Professional		$120.23	$131.83	$141.25
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $31.62 / $38.02	Professional	26	$28.84	$31.62	$38.02
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $40.74 / $91.20	Facility	26	$23.44	$40.74	$91.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $131.83 / $275.42	Professional		$87.10	$131.83	$275.42
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $33.88 / $67.61	Professional	26	$22.39	$33.88	$67.61
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $93.33 / $181.97	Professional	TC	$63.10	$93.33	$181.97
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $204.17	Professional		$72.44	$109.65	$204.17
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $30.90 / $30.90	Facility	26	$25.70	$30.90	$30.90
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $79.43 / $316.23	Professional		$17.38	$79.43	$316.23
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $30.90 / $30.90	Professional	26	$25.70	$30.90	$30.90
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $69.18 / $77.62	Professional	TC	$69.18	$69.18	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $114.82 / $181.97	Professional		$81.28	$114.82	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.84 / $45.71	Professional	26	$21.88	$28.84	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $87.10 / $138.04	Professional	TC	$61.66	$87.10	$138.04