Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $134.90 / $295.12	Facility	26	$67.61	$134.90	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $575.44 / $2,238.72	Professional		$380.19	$575.44	$2,238.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $95.50 / $223.87	Professional	26	$67.61	$95.50	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $407.38 / $891.25	Professional	TC	$302.00	$407.38	$891.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $346.74 / $562.34	Professional		$288.40	$346.74	$562.34
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $85.11 / $125.89	Professional	26	$60.26	$85.11	$125.89
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $281.84 / $309.03	Professional	TC	$234.42	$281.84	$309.03
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $575.44 / $851.14	Professional		$407.38	$575.44	$851.14
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $100.00 / $144.54	Professional	26	$74.13	$100.00	$144.54
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $478.63 / $707.95	Professional	TC	$331.13	$478.63	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $537.03 / $851.14	Professional		$323.59	$537.03	$851.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $91.20 / $144.54	Professional	26	$52.48	$91.20	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $446.68 / $707.95	Professional	TC	$263.03	$446.68	$707.95
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $616.60 / $616.60 / $724.44	Professional		$616.60	$616.60	$724.44
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $102.33 / $120.23	Professional	26	$102.33	$102.33	$120.23
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $512.86 / $512.86 / $616.60	Professional	TC	$512.86	$512.86	$616.60
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $575.44 / $870.96	Professional		$457.09	$575.44	$870.96
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $114.82 / $158.49	Professional	26	$83.18	$114.82	$158.49
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $467.74 / $724.44	Professional	TC	$363.08	$467.74	$724.44
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $120.23 / $120.23 / $1,445.44	Facility	26	$120.23	$120.23	$1,445.44
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Professional		$457.09	$457.09	$457.09
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $87.10 / $123.03	Professional	26	$79.43	$87.10	$123.03
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $676.08	Professional		$602.56	$602.56	$676.08
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $134.90 / $257.04	Facility	26	$67.61	$134.90	$257.04
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $588.84 / $1,621.81	Professional		$389.05	$588.84	$1,621.81
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $95.50 / $213.80	Professional	26	$67.61	$95.50	$213.80
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $446.68 / $912.01	Professional	TC	$323.59	$446.68	$912.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $776.25 / $954.99	Professional		$645.65	$776.25	$954.99
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $141.25 / $141.25	Facility	26	$74.13	$141.25	$141.25
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $436.52 / $933.25	Professional		$416.87	$436.52	$933.25
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $77.62 / $141.25	Professional	26	$74.13	$77.62	$141.25
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $380.19 / $501.19	Professional	TC	$346.74	$380.19	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $575.44 / $870.96	Professional		$416.87	$575.44	$870.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $97.72 / $154.88	Professional	26	$70.79	$97.72	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $457.09 / $724.44	Professional	TC	$338.84	$457.09	$724.44