Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $128.82 / $204.17	Facility	26	$52.48	$128.82	$204.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $346.74 / $660.69	Professional		$281.84	$346.74	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $66.07 / $138.04	Professional	26	$46.77	$66.07	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $288.40 / $602.56	Professional	TC	$234.42	$288.40	$602.56
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $436.52 / $660.69	Professional		$302.00	$436.52	$660.69
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $74.13 / $109.65	Professional	26	$54.95	$74.13	$109.65
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $363.08 / $549.54	Professional	TC	$245.47	$363.08	$549.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $416.87 / $660.69	Professional		$257.04	$416.87	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $69.18 / $107.15	Professional	26	$39.81	$69.18	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $354.81 / $549.54	Professional	TC	$208.93	$354.81	$549.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $524.81	Professional		$446.68	$446.68	$524.81
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $87.10	Professional	26	$74.13	$74.13	$87.10
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $371.54 / $436.52	Professional	TC	$371.54	$371.54	$436.52
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $407.38 / $616.60	Professional		$288.40	$407.38	$616.60
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $74.13 / $102.33	Professional	26	$52.48	$74.13	$102.33
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $331.13 / $512.86	Professional	TC	$234.42	$331.13	$512.86
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $53.70 / $64.57	Professional	26	$53.70	$53.70	$64.57
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $112.20 / $190.55	Facility	26	$52.48	$112.20	$190.55
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $380.19 / $851.14	Professional		$288.40	$380.19	$851.14
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $66.07 / $144.54	Professional	26	$48.98	$66.07	$144.54
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $323.59 / $741.31	Professional	TC	$239.88	$323.59	$741.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $562.34 / $707.95	Professional		$467.74	$562.34	$707.95
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $51.29 / $54.95	Facility	26	$51.29	$51.29	$54.95
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $218.78 / $338.84	Professional		$128.82	$218.78	$338.84
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $54.95 / $57.54	Professional	26	$51.29	$54.95	$57.54
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $257.04 / $281.84	Professional	TC	$257.04	$257.04	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $380.19 / $645.65	Professional		$309.03	$380.19	$645.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $66.07 / $109.65	Professional	26	$52.48	$66.07	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $331.13 / $537.03	Professional	TC	$257.04	$331.13	$537.03