Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $269.15 / $446.68	Facility	26	$117.49	$269.15	$446.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $354.81 / $724.44	Professional		$281.84	$354.81	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $109.65 / $302.00	Professional	26	$85.11	$109.65	$302.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $245.47 / $436.52	Professional	TC	$194.98	$245.47	$436.52
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $91.20 / $104.71	Professional	26	$91.20	$91.20	$104.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $354.81 / $575.44	Professional		$338.84	$354.81	$575.44
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $107.15 / $186.21	Professional	26	$102.33	$107.15	$186.21
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $245.47 / $398.11	Professional	TC	$234.42	$245.47	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $398.11 / $630.96	Professional		$275.42	$398.11	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $123.03 / $199.53	Professional	26	$81.28	$123.03	$199.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $275.42 / $436.52	Professional	TC	$190.55	$275.42	$436.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $478.63 / $588.84	Professional		$446.68	$478.63	$588.84
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $134.90 / $165.96	Professional	26	$134.90	$134.90	$165.96
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $338.84 / $426.58	Professional	TC	$316.23	$338.84	$426.58
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $407.38 / $660.69	Professional		$245.47	$407.38	$660.69
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $125.89 / $213.80	Professional	26	$79.43	$125.89	$213.80
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $288.40 / $446.68	Professional	TC	$165.96	$288.40	$446.68
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $645.65	Professional		$645.65	$645.65	$645.65
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $114.82 / $154.88	Professional	26	$104.71	$114.82	$154.88
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $223.87 / $398.11	Facility	26	$117.49	$223.87	$398.11
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $446.68 / $933.25	Professional		$295.12	$446.68	$933.25
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $144.54 / $295.12	Professional	26	$89.13	$144.54	$295.12
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $316.23 / $676.08	Professional	TC	$208.93	$316.23	$676.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $630.96 / $676.08	Professional		$213.80	$630.96	$676.08
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $109.65 / $109.65	Facility	26	$100.00	$109.65	$109.65
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $354.81 / $549.54	Professional		$323.59	$354.81	$549.54
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $100.00 / $109.65	Professional	26	$97.72	$100.00	$109.65
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $229.09 / $251.19	Professional	TC	$223.87	$229.09	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $371.54 / $630.96	Professional		$295.12	$371.54	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $117.49 / $194.98	Professional	26	$93.33	$117.49	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $263.03 / $436.52	Professional	TC	$199.53	$263.03	$436.52