Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $407.38 / $912.01 / $1,621.81	Facility	26	$407.38	$912.01	$1,621.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,621.81 / $2,398.83 / $9,772.37	Professional		$1,621.81	$2,398.83	$9,772.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $371.54 / $616.60 / $1,479.11	Professional	26	$371.54	$616.60	$1,479.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,202.26 / $1,737.80 / $6,025.60	Professional	TC	$1,202.26	$1,737.80	$6,025.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,380.38 / $2,089.30	Professional		$1,348.96	$1,380.38	$2,089.30
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $338.84 / $446.68 / $707.95	Professional	26	$338.84	$446.68	$707.95
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,778.28 / $2,187.76 / $3,467.37	Professional		$1,778.28	$2,187.76	$3,467.37
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $426.58 / $489.78 / $933.25	Professional	26	$426.58	$489.78	$933.25
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $1,348.96 / $1,737.80 / $2,754.23	Professional	TC	$1,348.96	$1,737.80	$2,754.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,187.76 / $3,548.13	Professional		$1,445.44	$2,187.76	$3,548.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $338.84 / $489.78 / $812.83	Professional	26	$338.84	$489.78	$812.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,096.48 / $1,698.24 / $2,818.38	Professional	TC	$1,096.48	$1,698.24	$2,818.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,511.89 / $2,691.53 / $3,388.44	Professional		$2,511.89	$2,691.53	$3,388.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $549.54 / $562.34 / $691.83	Professional	26	$549.54	$562.34	$691.83
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,995.26 / $2,089.30 / $2,691.53	Professional	TC	$1,995.26	$2,089.30	$2,691.53
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $2,344.23 / $3,890.45	Professional		$1,122.02	$2,344.23	$3,890.45
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $323.59 / $512.86 / $831.76	Professional	26	$323.59	$512.86	$831.76
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $812.83 / $1,862.09 / $3,090.30	Professional	TC	$812.83	$1,862.09	$3,090.30
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $2,041.74 / $2,238.72 / $3,388.44	Professional		$2,041.74	$2,238.72	$3,388.44
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $426.58 / $478.63 / $630.96	Professional	26	$426.58	$478.63	$630.96
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $389.05 / $794.33 / $1,513.56	Facility	26	$389.05	$794.33	$1,513.56
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,659.59 / $2,570.40 / $5,888.44	Professional		$1,659.59	$2,570.40	$5,888.44
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $371.54 / $588.84 / $1,288.25	Professional	26	$371.54	$588.84	$1,288.25
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $1,258.93 / $1,995.26 / $3,981.07	Professional	TC	$1,258.93	$1,995.26	$3,981.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,570.40 / $3,630.78 / $4,265.80	Professional		$2,570.40	$3,630.78	$4,265.80
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $407.38 / $416.87 / $446.68	Facility	26	$407.38	$416.87	$446.68
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $1,737.80 / $1,905.46	Professional		$316.23	$1,737.80	$1,905.46
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $407.38 / $416.87 / $426.58	Professional	26	$407.38	$416.87	$426.58
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $1,318.26 / $1,348.96 / $1,479.11	Professional	TC	$1,318.26	$1,348.96	$1,479.11
United Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,089.30 / $3,548.13	Professional		$1,445.44	$2,089.30	$3,548.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $371.54 / $478.63 / $794.33	Professional	26	$371.54	$478.63	$794.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $1,230.27 / $1,659.59 / $2,818.38	Professional	TC	$1,230.27	$1,659.59	$2,818.38