Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $204.17 / $416.87	Facility	26	$102.33	$204.17	$416.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $512.86 / $2,238.72	Professional		$316.23	$512.86	$2,238.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $165.96 / $436.52	Professional	26	$97.72	$165.96	$436.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $288.40 / $691.83	Professional	TC	$208.93	$288.40	$691.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $275.42 / $309.03	Professional		$251.19	$275.42	$309.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $151.36 / $181.97	Professional	26	$89.13	$151.36	$181.97
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $302.00 / $354.81	Professional	TC	$302.00	$302.00	$354.81
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $346.74 / $724.44	Professional		$338.84	$346.74	$724.44
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $112.20 / $213.80	Professional	26	$109.65	$112.20	$213.80
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $234.42 / $524.81	Professional	TC	$229.09	$234.42	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $125.89 / $177.83	Facility	26	$26.92	$125.89	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $478.63 / $794.33	Professional		$281.84	$478.63	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $134.90 / $223.87	Professional	26	$79.43	$134.90	$223.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $338.84 / $549.54	Professional	TC	$204.17	$338.84	$549.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $457.09 / $575.44	Professional		$354.81	$457.09	$575.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $141.25 / $173.78	Professional	26	$107.15	$141.25	$173.78
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $323.59 / $407.38	Professional	TC	$251.19	$323.59	$407.38
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $398.11 / $707.95	Professional		$316.23	$398.11	$707.95
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $123.03 / $229.09	Professional	26	$102.33	$123.03	$229.09
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $281.84 / $478.63	Professional	TC	$213.80	$281.84	$478.63
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $436.52 / $562.34	Professional		$389.05	$436.52	$562.34
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $123.03 / $169.82	Professional	26	$114.82	$123.03	$169.82
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $354.81 / $426.58	Professional	TC	$323.59	$354.81	$426.58
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $407.38 / $524.81	Professional		$389.05	$407.38	$524.81
Independence Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $407.38 / $489.78	Professional	26	$123.03	$407.38	$489.78
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $102.33 / $204.17 / $416.87	Facility	26	$102.33	$204.17	$416.87
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $478.63 / $1,096.48	Professional		$316.23	$478.63	$1,096.48
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $154.88 / $323.59	Professional	26	$97.72	$154.88	$323.59
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $323.59 / $616.60	Professional	TC	$218.78	$323.59	$616.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $446.68 / $660.69	Professional		$194.98	$446.68	$660.69
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $125.89	Facility	26	$107.15	$107.15	$125.89
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $338.84 / $407.38	Professional		$125.89	$338.84	$407.38
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $107.15 / $112.20	Professional	26	$104.71	$107.15	$112.20
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $239.88 / $263.03	Professional	TC	$234.42	$239.88	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $512.86 / $1,047.13	Professional		$338.84	$512.86	$1,047.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $109.65 / $199.53	Professional	26	$72.44	$109.65	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $346.74 / $912.01	Professional	TC	$234.42	$346.74	$912.01