Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $331.13 / $588.84	Facility	26	$141.25	$331.13	$588.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $302.00 / $812.83	Professional		$234.42	$302.00	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $213.80 / $537.03	Professional	26	$131.83	$213.80	$537.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $144.54 / $346.74	Professional	TC	$109.65	$144.54	$346.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $218.78 / $218.78	Professional		$218.78	$218.78	$218.78
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $162.18 / $288.40	Professional	26	$123.03	$162.18	$288.40
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $295.12 / $524.81	Professional		$288.40	$295.12	$524.81
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $158.49 / $275.42	Professional	26	$154.88	$158.49	$275.42
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $138.04 / $245.47	Professional	TC	$131.83	$138.04	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $346.74 / $549.54	Professional		$229.09	$346.74	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $181.97 / $295.12	Professional	26	$117.49	$181.97	$295.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $158.49 / $251.19	Professional	TC	$109.65	$158.49	$251.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $389.05 / $489.78	Professional		$380.19	$389.05	$489.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $204.17 / $251.19	Professional	26	$199.53	$204.17	$251.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $190.55 / $239.88	Professional	TC	$177.83	$190.55	$239.88
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $354.81 / $588.84	Professional		$218.78	$354.81	$588.84
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $190.55 / $316.23	Professional	26	$117.49	$190.55	$316.23
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $165.96 / $269.15	Professional	TC	$100.00	$165.96	$269.15
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $288.40 / $354.81	Professional		$288.40	$288.40	$354.81
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $169.82 / $229.09	Professional	26	$154.88	$169.82	$229.09
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $288.40 / $549.54	Facility	26	$141.25	$288.40	$549.54
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $363.08 / $776.25	Professional		$245.47	$363.08	$776.25
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $204.17 / $467.74	Professional	26	$131.83	$204.17	$467.74
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $173.78 / $380.19	Professional	TC	$112.20	$173.78	$380.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $512.86 / $741.31	Professional		$309.03	$512.86	$741.31
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $151.36 / $162.18	Facility	26	$151.36	$151.36	$162.18
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $295.12 / $354.81	Professional		$60.26	$295.12	$354.81
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $151.36 / $162.18	Professional	26	$147.91	$151.36	$162.18
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $125.89 / $138.04	Professional	TC	$123.03	$125.89	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $316.23 / $537.03	Professional		$257.04	$316.23	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $173.78 / $288.40	Professional	26	$138.04	$173.78	$288.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $151.36 / $251.19	Professional	TC	$117.49	$151.36	$251.19