Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $85.11 / $162.18	Facility	26	$42.66	$85.11	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $229.09 / $616.60	Professional		$123.03	$229.09	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $81.28 / $181.97	Professional	26	$42.66	$81.28	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $117.49 / $251.19	Professional	TC	$72.44	$117.49	$251.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $112.20 / $194.98	Professional		$87.10	$112.20	$194.98
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $51.29 / $79.43	Professional	26	$38.02	$51.29	$79.43
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $69.18 / $128.82	Professional	TC	$56.23	$69.18	$128.82
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $288.40	Professional		$128.82	$169.82	$288.40
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $63.10 / $117.49	Professional	26	$46.77	$63.10	$117.49
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $109.65 / $173.78	Professional	TC	$83.18	$109.65	$173.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $53.70 / $77.62	Facility	26	$11.48	$53.70	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $165.96 / $263.03	Professional		$109.65	$165.96	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $58.88 / $93.33	Professional	26	$38.02	$58.88	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $107.15 / $169.82	Professional	TC	$70.79	$107.15	$169.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $190.55 / $229.09	Professional		$162.18	$190.55	$229.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $63.10 / $77.62	Professional	26	$40.74	$63.10	$77.62
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $123.03 / $154.88	Professional	TC	$79.43	$123.03	$154.88
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $165.96 / $281.84	Professional		$109.65	$165.96	$281.84
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $60.26 / $95.50	Professional	26	$40.74	$60.26	$95.50
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $102.33 / $177.83	Professional	TC	$64.57	$102.33	$177.83
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $158.49 / $234.42	Professional		$144.54	$158.49	$234.42
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $54.95 / $77.62	Professional	26	$51.29	$54.95	$77.62
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $117.49 / $134.90	Professional	TC	$89.13	$117.49	$134.90
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $42.66 / $72.44 / $162.18	Facility	26	$42.66	$72.44	$162.18
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $199.53 / $407.38	Professional		$120.23	$199.53	$407.38
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $67.61 / $151.36	Professional	26	$41.69	$67.61	$151.36
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $114.82 / $218.78	Professional	TC	$75.86	$114.82	$218.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $229.09 / $302.00	Professional		$97.72	$229.09	$302.00
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $53.70 / $53.70	Facility	26	$46.77	$53.70	$53.70
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $97.72 / $338.84	Professional		$58.88	$97.72	$338.84
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $47.86 / $53.70	Professional	26	$45.71	$47.86	$53.70
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $85.11 / $93.33	Professional	TC	$83.18	$85.11	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $141.25 / $229.09	Professional		$109.65	$141.25	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $51.29 / $83.18	Professional	26	$38.90	$51.29	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $93.33 / $151.36	Professional	TC	$70.79	$93.33	$151.36