Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $42.66 / $63.10	Facility	26	$15.85	$42.66	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $44.67 / $120.23	Professional		$33.88	$44.67	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.98 / $75.86	Professional	26	$12.88	$16.98	$75.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.18 / $63.10	Professional	TC	$19.95	$28.18	$63.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $37.15 / $37.15	Professional		$37.15	$37.15	$37.15
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $19.50	Professional	26	$19.50	$19.50	$19.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $4.07 / $4.07 / $4.07	Professional	TC	$4.07	$4.07	$4.07
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $46.77 / $79.43	Professional		$44.67	$46.77	$79.43
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.98 / $30.20	Professional	26	$16.22	$16.98	$30.20
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $29.51 / $48.98	Professional	TC	$28.84	$29.51	$48.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.98 / $18.62 / $26.92	Facility	26	$3.98	$18.62	$26.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $56.23 / $89.13	Professional		$33.88	$56.23	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $19.50 / $33.11	Professional	26	$12.02	$19.50	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $35.48 / $57.54	Professional	TC	$22.91	$35.48	$57.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $61.66 / $81.28	Professional		$41.69	$61.66	$81.28
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $21.88 / $26.92	Professional	26	$16.60	$21.88	$26.92
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $42.66 / $53.70	Professional	TC	$33.11	$42.66	$53.70
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $100.00	Professional		$39.81	$54.95	$100.00
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $19.05 / $35.48	Professional	26	$12.59	$19.05	$35.48
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $36.31 / $64.57	Professional	TC	$26.92	$36.31	$64.57
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $22.39 / $23.99	Professional	26	$16.98	$22.39	$23.99
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $35.48 / $60.26	Facility	26	$17.78	$35.48	$60.26
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $51.29 / $117.49	Professional		$37.15	$51.29	$117.49
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $19.50 / $47.86	Professional	26	$13.80	$19.50	$47.86
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $32.36 / $70.79	Professional	TC	$22.91	$32.36	$70.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $77.62 / $91.20	Professional		$72.44	$77.62	$91.20
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $16.22 / $16.22	Facility	26	$15.14	$16.22	$16.22
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $35.48 / $75.86	Professional		$14.79	$35.48	$75.86
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $16.22 / $16.98	Professional	26	$15.85	$16.22	$16.98
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $28.84 / $32.36	Professional	TC	$28.18	$28.84	$32.36
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $48.98 / $79.43	Professional		$37.15	$48.98	$79.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $17.78 / $30.90	Professional	26	$12.59	$17.78	$30.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.20 / $50.12	Professional	TC	$22.39	$30.20	$50.12