Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $45.71 / $81.28	Facility	26	$22.91	$45.71	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $77.62 / $275.42	Professional		$38.90	$77.62	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $40.74 / $128.82	Professional	26	$20.42	$40.74	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $24.55 / $61.66	Professional	TC	$16.98	$24.55	$61.66
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $34.67 / $66.07	Professional		$30.20	$34.67	$66.07
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $23.99 / $40.74	Professional	26	$18.20	$23.99	$40.74
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $31.62 / $31.62	Professional	TC	$31.62	$31.62	$31.62
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $44.67 / $117.49	Professional		$43.65	$44.67	$117.49
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $24.55 / $60.26	Professional	26	$23.44	$24.55	$60.26
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $26.30 / $63.10	Professional	TC	$19.50	$26.30	$63.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.75 / $26.92 / $38.02	Facility	26	$5.75	$26.92	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $63.10 / $117.49	Professional		$38.02	$63.10	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $30.20 / $46.77	Professional	26	$19.05	$30.20	$46.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $31.62 / $70.79	Professional	TC	$17.78	$31.62	$70.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $61.66 / $75.86	Professional		$53.70	$61.66	$75.86
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $32.36 / $38.90	Professional	26	$20.89	$32.36	$38.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $28.84 / $36.31	Professional	TC	$18.62	$28.84	$36.31
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $66.07 / $107.15	Professional		$44.67	$66.07	$107.15
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $31.62 / $48.98	Professional	26	$21.38	$31.62	$48.98
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.11 / $64.57	Professional	TC	$21.38	$33.11	$64.57
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Facility	26	$141.25	$141.25	$141.25
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $57.54 / $93.33	Professional		$50.12	$57.54	$93.33
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $28.84 / $42.66	Professional	26	$25.70	$28.84	$42.66
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $30.90 / $33.11	Professional	TC	$30.90	$30.90	$33.11
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $45.71 / $81.28	Facility	26	$23.44	$45.71	$81.28
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $66.07 / $177.83	Professional		$39.81	$66.07	$177.83
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $34.67 / $85.11	Professional	26	$20.42	$34.67	$85.11
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.92 / $60.26	Professional	TC	$17.78	$26.92	$60.26
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $89.13 / $117.49	Professional		$37.15	$89.13	$117.49
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $26.92 / $26.92	Facility	26	$23.44	$26.92	$26.92
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $42.66 / $77.62	Professional		$16.60	$42.66	$77.62
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $23.99 / $26.92	Professional	26	$22.91	$23.99	$26.92
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $20.42 / $61.66	Professional	TC	$19.95	$20.42	$61.66
United Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $52.48 / $91.20	Professional		$38.90	$52.48	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.30 / $42.66	Professional	26	$19.50	$26.30	$42.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $23.99 / $54.95	Professional	TC	$17.38	$23.99	$54.95