Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $61.66 / $117.49	Facility	26	$30.90	$61.66	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $190.55 / $467.74	Professional		$114.82	$190.55	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $47.86 / $158.49	Professional	26	$28.18	$47.86	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $107.15 / $190.55	Professional	TC	$75.86	$107.15	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $154.88 / $208.93	Professional		$95.50	$154.88	$208.93
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $30.20 / $53.70	Professional	26	$25.12	$30.20	$53.70
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $141.25 / $229.09	Professional		$138.04	$141.25	$229.09
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $33.11 / $81.28	Professional	26	$32.36	$33.11	$81.28
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $107.15 / $173.78	Professional	TC	$104.71	$107.15	$173.78
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 $89.13 / $165.96 / $316.23	Professional		$89.13	$165.96	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $40.74 / $64.57	Professional	26	$26.30	$40.74	$64.57
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $125.89 / $257.04	Professional	TC	$66.07	$125.89	$257.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $169.82 / $204.17	Professional		$144.54	$169.82	$204.17
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $42.66 / $51.29	Professional	26	$27.54	$42.66	$51.29
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $123.03 / $151.36	Professional	TC	$77.62	$123.03	$151.36
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $141.25 / $245.47	Professional		$97.72	$141.25	$245.47
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $41.69 / $64.57	Professional	26	$30.90	$41.69	$64.57
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $102.33 / $173.78	Professional	TC	$64.57	$102.33	$173.78
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $229.09 / $309.03	Professional		$125.89	$229.09	$309.03
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.02 / $50.12	Professional	26	$36.31	$38.02	$50.12
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $144.54 / $144.54	Professional		$144.54	$144.54	$144.54
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $60.26 / $112.20	Facility	26	$30.20	$60.26	$112.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $169.82 / $354.81	Professional		$114.82	$169.82	$354.81
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $42.66 / $93.33	Professional	26	$28.18	$42.66	$93.33
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $114.82 / $223.87	Professional	TC	$79.43	$114.82	$223.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $169.82 / $257.04	Professional		$117.49	$169.82	$257.04
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $37.15 / $37.15	Facility	26	$31.62	$37.15	$37.15
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $97.72 / $309.03	Professional		$52.48	$97.72	$309.03
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $31.62 / $37.15	Professional	26	$30.90	$31.62	$37.15
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $100.00 / $109.65	Professional	TC	$95.50	$100.00	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $151.36 / $239.88	Professional		$95.50	$151.36	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $35.48 / $56.23	Professional	26	$26.92	$35.48	$56.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $123.03 / $199.53	Professional	TC	$70.79	$123.03	$199.53