Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $120.23 / $229.09	Facility	26	$57.54	$120.23	$229.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $239.88 / $1,258.93	Professional		$114.82	$239.88	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $218.78 / $870.96	Professional	26	$57.54	$218.78	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $95.50 / $389.05	Professional	TC	$54.95	$95.50	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $95.50 / $147.91	Professional		$91.20	$95.50	$147.91
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $63.10 / $114.82	Professional	26	$47.86	$63.10	$114.82
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $158.49 / $316.23	Professional		$123.03	$158.49	$316.23
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $75.86 / $144.54	Professional	26	$60.26	$75.86	$144.54
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $81.28 / $165.96	Professional	TC	$63.10	$81.28	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $173.78 / $269.15	Professional		$112.20	$173.78	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $74.13 / $117.49	Professional	26	$48.98	$74.13	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $102.33 / $165.96	Professional	TC	$60.26	$102.33	$165.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $169.82 / $213.80	Professional		$162.18	$169.82	$213.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $79.43 / $97.72	Professional	26	$79.43	$79.43	$97.72
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $91.20 / $114.82	Professional	TC	$85.11	$91.20	$114.82
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $173.78 / $295.12	Professional		$134.90	$173.78	$295.12
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $77.62 / $128.82	Professional	26	$50.12	$77.62	$128.82
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $102.33 / $177.83	Professional	TC	$75.86	$102.33	$177.83
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $218.78 / $245.47	Professional		$141.25	$218.78	$245.47
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $70.79 / $100.00	Professional	26	$66.07	$70.79	$100.00
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $114.82 / $204.17	Facility	26	$57.54	$114.82	$204.17
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $194.98 / $741.31	Professional		$114.82	$194.98	$741.31
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $114.82 / $691.83	Professional	26	$57.54	$114.82	$691.83
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $97.72 / $208.93	Professional	TC	$58.88	$97.72	$208.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $239.88 / $323.59	Professional		$204.17	$239.88	$323.59
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $66.07 / $66.07	Facility	26	$58.88	$66.07	$66.07
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $120.23 / $338.84	Professional		$50.12	$120.23	$338.84
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $60.26 / $66.07	Professional	26	$58.88	$60.26	$66.07
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $63.10 / $138.04	Professional	TC	$60.26	$63.10	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $239.88	Professional		$112.20	$158.49	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $69.18 / $114.82	Professional	26	$54.95	$69.18	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $81.28 / $141.25	Professional	TC	$57.54	$81.28	$141.25