Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $125.89 / $234.42	Facility	26	$60.26	$125.89	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $354.81 / $870.96	Professional		$263.03	$354.81	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $75.86 / $229.09	Professional	26	$53.70	$75.86	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $269.15 / $489.78	Professional	TC	$208.93	$269.15	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $81.28 / $81.28	Professional	26	$81.28	$81.28	$81.28
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $416.87 / $616.60	Professional		$295.12	$416.87	$616.60
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $85.11 / $123.03	Professional	26	$63.10	$85.11	$123.03
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $331.13 / $489.78	Professional	TC	$229.09	$331.13	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $380.19 / $616.60	Professional		$234.42	$380.19	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $77.62 / $123.03	Professional	26	$44.67	$77.62	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $302.00 / $489.78	Professional	TC	$186.21	$302.00	$489.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $446.68 / $537.03	Professional		$446.68	$446.68	$537.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $85.11 / $102.33	Professional	26	$85.11	$85.11	$102.33
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $363.08 / $426.58	Professional	TC	$363.08	$363.08	$426.58
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $416.87 / $645.65	Professional		$331.13	$416.87	$645.65
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $95.50 / $134.90	Professional	26	$70.79	$95.50	$134.90
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $331.13 / $501.19	Professional	TC	$257.04	$331.13	$501.19
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $74.13 / $107.15	Professional	26	$66.07	$74.13	$107.15
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $123.03 / $218.78	Facility	26	$60.26	$123.03	$218.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $380.19 / $891.25	Professional		$281.84	$380.19	$891.25
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $79.43 / $186.21	Professional	26	$56.23	$79.43	$186.21
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $302.00 / $676.08	Professional	TC	$223.87	$302.00	$676.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $562.34 / $691.83	Professional		$467.74	$562.34	$691.83
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $63.10 / $114.82	Facility	26	$63.10	$63.10	$114.82
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $309.03 / $371.54	Professional		$251.19	$309.03	$371.54
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $64.57 / $114.82	Professional	26	$61.66	$64.57	$114.82
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $251.19 / $263.03	Professional	TC	$239.88	$251.19	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $407.38 / $616.60	Professional		$295.12	$407.38	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $83.18 / $128.82	Professional	26	$60.26	$83.18	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $309.03 / $489.78	Professional	TC	$234.42	$309.03	$489.78