Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $77.62 / $138.04	Facility	26	$36.31	$77.62	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $181.97 / $549.54	Professional		$97.72	$181.97	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $69.18 / $218.78	Professional	26	$36.31	$69.18	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $89.13 / $346.74	Professional	TC	$56.23	$89.13	$346.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $89.13 / $134.90	Professional		$75.86	$89.13	$134.90
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $46.77 / $75.86	Professional	26	$33.88	$46.77	$75.86
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $60.26 / $102.33	Professional	TC	$46.77	$60.26	$102.33
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $141.25 / $204.17	Professional		$112.20	$141.25	$204.17
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $54.95 / $102.33	Professional	26	$42.66	$54.95	$102.33
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $87.10 / $125.89	Professional	TC	$69.18	$87.10	$125.89
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $45.71 / $66.07	Facility	26	$9.77	$45.71	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $125.89 / $213.80	Professional		$85.11	$125.89	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $50.12 / $81.28	Professional	26	$32.36	$50.12	$81.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $77.62 / $131.83	Professional	TC	$47.86	$77.62	$131.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $154.88 / $186.21	Professional		$131.83	$154.88	$186.21
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $54.95 / $66.07	Professional	26	$34.67	$54.95	$66.07
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $97.72 / $123.03	Professional	TC	$61.66	$97.72	$123.03
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $208.93	Professional		$79.43	$125.89	$208.93
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $52.48 / $83.18	Professional	26	$35.48	$52.48	$83.18
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $74.13 / $128.82	Professional	TC	$38.90	$74.13	$128.82
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $457.09 / $457.09 / $512.86	Facility	26	$457.09	$457.09	$512.86
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $128.82 / $181.97	Professional		$114.82	$128.82	$181.97
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $47.86 / $66.07	Professional	26	$43.65	$47.86	$66.07
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $91.20 / $107.15	Professional	TC	$64.57	$91.20	$107.15
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $162.18 / $204.17	Professional		$141.25	$162.18	$204.17
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $56.23 / $81.28	Professional	26	$50.12	$56.23	$81.28
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $72.44 / $138.04	Facility	26	$36.31	$72.44	$138.04
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $162.18 / $389.05	Professional		$95.50	$162.18	$389.05
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $60.26 / $151.36	Professional	26	$36.31	$60.26	$151.36
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $87.10 / $173.78	Professional	TC	$56.23	$87.10	$173.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $169.82 / $234.42	Professional		$79.43	$169.82	$234.42
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $47.86 / $47.86	Facility	26	$39.81	$47.86	$47.86
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $74.13 / $147.91	Professional		$12.88	$74.13	$147.91
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $41.69 / $47.86	Professional	26	$39.81	$41.69	$47.86
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $64.57 / $72.44	Professional	TC	$60.26	$64.57	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $114.82 / $181.97	Professional		$77.62	$114.82	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $44.67 / $72.44	Professional	26	$33.11	$44.67	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $72.44 / $117.49	Professional	TC	$51.29	$72.44	$117.49