Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $147.91 / $288.40	Facility	26	$77.62	$147.91	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $181.97 / $660.69	Professional		$131.83	$181.97	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $97.72 / $234.42	Professional	26	$57.54	$97.72	$234.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $104.71 / $239.88	Professional	TC	$67.61	$104.71	$239.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $83.18	Professional		$83.18	$83.18	$83.18
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $72.44 / $114.82	Professional	26	$53.70	$72.44	$114.82
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $128.82 / $239.88	Professional		$123.03	$128.82	$239.88
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $72.44 / $123.03	Professional	26	$69.18	$72.44	$123.03
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $56.23 / $134.90	Professional	TC	$54.95	$56.23	$134.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.98 / $79.43 / $112.20	Facility	26	$16.98	$79.43	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $199.53 / $389.05	Professional		$112.20	$199.53	$389.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $74.13 / $138.04	Professional	26	$48.98	$74.13	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $112.20 / $302.00	Professional	TC	$56.23	$112.20	$302.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $204.17	Professional		$128.82	$165.96	$204.17
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $89.13 / $109.65	Professional	26	$67.61	$89.13	$109.65
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $75.86 / $95.50	Professional	TC	$60.26	$75.86	$95.50
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $218.78 / $354.81	Professional		$128.82	$218.78	$354.81
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $75.86 / $128.82	Professional	26	$50.12	$75.86	$128.82
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $112.20 / $251.19	Professional	TC	$56.23	$112.20	$251.19
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $154.88	Professional		$138.04	$138.04	$154.88
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $79.43 / $114.82	Professional	26	$70.79	$79.43	$114.82
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $141.25 / $257.04	Facility	26	$77.62	$141.25	$257.04
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $194.98 / $416.87	Professional		$134.90	$194.98	$416.87
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $91.20 / $199.53	Professional	26	$57.54	$91.20	$199.53
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $107.15 / $239.88	Professional	TC	$67.61	$107.15	$239.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $234.42 / $323.59	Professional		$83.18	$234.42	$323.59
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $69.18	Facility	26	$61.66	$61.66	$69.18
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $144.54 / $380.19	Professional		$30.90	$144.54	$380.19
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $69.18 / $70.79	Professional	26	$61.66	$69.18	$70.79
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $67.61 / $316.23	Professional	TC	$66.07	$67.61	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $173.78 / $309.03	Professional		$125.89	$173.78	$309.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $72.44 / $120.23	Professional	26	$48.98	$72.44	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $87.10 / $223.87	Professional	TC	$61.66	$87.10	$223.87