Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $162.18 / $269.15	Facility	26	$67.61	$162.18	$269.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $275.42 / $588.84	Professional		$204.17	$275.42	$588.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $67.61 / $158.49	Professional	26	$52.48	$67.61	$158.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $199.53 / $537.03	Professional	TC	$147.91	$199.53	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $218.78 / $398.11	Professional		$208.93	$218.78	$398.11
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $63.10 / $114.82	Professional	26	$61.66	$63.10	$114.82
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $154.88 / $288.40	Professional	TC	$151.36	$154.88	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $389.05 / $812.83	Professional		$190.55	$389.05	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $72.44 / $114.82	Professional	26	$42.66	$72.44	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $288.40 / $707.95	Professional	TC	$138.04	$288.40	$707.95
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $302.00 / $380.19	Professional		$288.40	$302.00	$380.19
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $97.72	Professional	26	$79.43	$79.43	$97.72
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $218.78 / $275.42	Professional	TC	$208.93	$218.78	$275.42
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $354.81 / $616.60	Professional		$239.88	$354.81	$616.60
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $75.86 / $125.89	Professional	26	$48.98	$75.86	$125.89
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $263.03 / $512.86	Professional	TC	$181.97	$263.03	$512.86
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $162.18 / $251.19	Facility	26	$67.61	$162.18	$251.19
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $309.03 / $707.95	Professional		$208.93	$309.03	$707.95
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $74.13 / $173.78	Professional	26	$54.95	$74.13	$173.78
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $239.88 / $537.03	Professional	TC	$151.36	$239.88	$537.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $398.11 / $478.63	Professional		$323.59	$398.11	$478.63
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $63.10 / $63.10	Facility	26	$60.26	$63.10	$63.10
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $426.58 / $467.74	Professional		$199.53	$426.58	$467.74
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $63.10 / $63.10	Professional	26	$58.88	$63.10	$63.10
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $169.82 / $363.08	Professional	TC	$151.36	$169.82	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $302.00 / $602.56	Professional		$204.17	$302.00	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $69.18 / $117.49	Professional	26	$51.29	$69.18	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $208.93 / $537.03	Professional	TC	$144.54	$208.93	$537.03