Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $58.88 / $112.20	Facility	26	$29.51	$58.88	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $162.18 / $630.96	Professional		$87.10	$162.18	$630.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $46.77 / $131.83	Professional	26	$28.84	$46.77	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $95.50 / $416.87	Professional	TC	$60.26	$95.50	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $114.82	Professional		$66.07	$83.18	$114.82
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $29.51 / $54.95	Professional	26	$25.70	$29.51	$54.95
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $58.88 / $107.15	Professional	TC	$39.81	$58.88	$107.15
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $194.98 / $208.93	Professional		$120.23	$194.98	$208.93
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $43.65 / $81.28	Professional	26	$32.36	$43.65	$81.28
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $104.71 / $134.90	Professional	TC	$69.18	$104.71	$134.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $37.15 / $52.48	Facility	26	$7.94	$37.15	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $128.82 / $213.80	Professional		$85.11	$128.82	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $40.74 / $66.07	Professional	26	$26.30	$40.74	$66.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $87.10 / $147.91	Professional	TC	$56.23	$87.10	$147.91
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $147.91 / $177.83	Professional		$125.89	$147.91	$177.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $43.65 / $52.48	Professional	26	$27.54	$43.65	$52.48
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $100.00 / $125.89	Professional	TC	$64.57	$100.00	$125.89
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $128.82 / $213.80	Professional		$83.18	$128.82	$213.80
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $42.66 / $66.07	Professional	26	$29.51	$42.66	$66.07
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $87.10 / $147.91	Professional	TC	$50.12	$87.10	$147.91
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Facility	26	$138.04	$138.04	$138.04
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $125.89 / $162.18	Professional		$117.49	$125.89	$162.18
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $38.90 / $61.66	Professional	26	$35.48	$38.90	$61.66
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $109.65 / $131.83	Professional	TC	$83.18	$109.65	$131.83
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $69.18 / $91.20	Professional		$60.26	$69.18	$91.20
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $35.48 / $52.48	Professional	26	$20.42	$35.48	$52.48
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $48.98 / $112.20	Facility	26	$29.51	$48.98	$112.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $144.54 / $309.03	Professional		$93.33	$144.54	$309.03
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $44.67 / $100.00	Professional	26	$28.84	$44.67	$100.00
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $95.50 / $186.21	Professional	TC	$63.10	$95.50	$186.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $131.83 / $257.04	Professional		$57.54	$131.83	$257.04
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $60.26	Facility	26	$32.36	$32.36	$60.26
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $63.10 / $275.42	Professional		$53.70	$63.10	$275.42
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $32.36 / $60.26	Professional	26	$31.62	$32.36	$60.26
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $69.18 / $75.86	Professional	TC	$67.61	$69.18	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $181.97	Professional		$83.18	$112.20	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $35.48 / $57.54	Professional	26	$27.54	$35.48	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $77.62 / $128.82	Professional	TC	$57.54	$77.62	$128.82