Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $43.65 / $81.28	Facility	26	$20.89	$43.65	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $245.47 / $1,148.15	Professional		$194.98	$245.47	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $32.36 / $75.86	Professional	26	$19.95	$32.36	$75.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $213.80 / $426.58	Professional	TC	$169.82	$213.80	$426.58
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $33.88 / $38.90	Professional	26	$19.50	$33.88	$38.90
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $169.82 / $169.82	Professional	TC	$169.82	$169.82	$169.82
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $295.12 / $436.52	Professional		$204.17	$295.12	$436.52
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $30.90 / $46.77	Professional	26	$23.44	$30.90	$46.77
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $263.03 / $398.11	Professional	TC	$181.97	$263.03	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $281.84 / $436.52	Professional		$173.78	$281.84	$436.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $28.84 / $45.71	Professional	26	$16.98	$28.84	$45.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $251.19 / $389.05	Professional	TC	$154.88	$251.19	$389.05
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $363.08	Professional		$302.00	$302.00	$363.08
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $30.90 / $37.15	Professional	26	$30.90	$30.90	$37.15
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $275.42 / $323.59	Professional	TC	$275.42	$275.42	$323.59
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $275.42 / $416.87	Professional		$194.98	$275.42	$416.87
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $30.90 / $43.65	Professional	26	$22.39	$30.90	$43.65
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $239.88 / $371.54	Professional	TC	$173.78	$239.88	$371.54
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $24.55 / $33.88	Professional	26	$16.22	$24.55	$33.88
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $40.74 / $81.28	Facility	26	$20.89	$40.74	$81.28
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $263.03 / $630.96	Professional		$194.98	$263.03	$630.96
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $30.20 / $67.61	Professional	26	$19.95	$30.20	$67.61
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $234.42 / $524.81	Professional	TC	$173.78	$234.42	$524.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $208.93 / $416.87	Professional		$23.99	$208.93	$416.87
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $22.91 / $22.91	Facility	26	$21.88	$22.91	$22.91
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $97.72 / $213.80	Professional		$33.11	$97.72	$213.80
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $22.91 / $23.99	Professional	26	$21.88	$22.91	$23.99
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $190.55 / $208.93	Professional	TC	$186.21	$190.55	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $257.04 / $436.52	Professional		$208.93	$257.04	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $26.92 / $44.67	Professional	26	$21.88	$26.92	$44.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $239.88 / $398.11	Professional	TC	$186.21	$239.88	$398.11