Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.70 / $104.71 / $190.55	Facility	26	$53.70	$104.71	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $199.53 / $776.25	Professional		$151.36	$199.53	$776.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $91.20 / $213.80	Professional	26	$50.12	$91.20	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $128.82 / $302.00	Professional	TC	$97.72	$128.82	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $52.48 / $104.71	Professional	26	$48.98	$52.48	$104.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $177.83 / $316.23	Professional		$169.82	$177.83	$316.23
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $57.54 / $107.15	Professional	26	$56.23	$57.54	$107.15
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $120.23 / $208.93	Professional	TC	$114.82	$120.23	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $223.87 / $338.84	Professional		$141.25	$223.87	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $69.18 / $109.65	Professional	26	$38.90	$69.18	$109.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $151.36 / $239.88	Professional	TC	$95.50	$151.36	$239.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $245.47 / $295.12	Professional		$245.47	$245.47	$295.12
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 $169.82 / $169.82 / $204.17	Professional	TC	$169.82	$169.82	$204.17
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $229.09 / $354.81	Professional		$173.78	$229.09	$354.81
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $74.13 / $117.49	Professional	26	$52.48	$74.13	$117.49
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $154.88 / $239.88	Professional	TC	$117.49	$154.88	$239.88
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $66.07 / $81.28	Professional	26	$57.54	$66.07	$81.28
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $104.71 / $190.55	Facility	26	$54.95	$104.71	$190.55
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $208.93 / $524.81	Professional		$151.36	$208.93	$524.81
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $77.62 / $199.53	Professional	26	$50.12	$77.62	$199.53
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $141.25 / $331.13	Professional	TC	$100.00	$141.25	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $323.59 / $371.54	Professional		$263.03	$323.59	$371.54
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $63.10 / $63.10	Facility	26	$54.95	$63.10	$63.10
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $138.04 / $213.80	Professional		$58.88	$138.04	$213.80
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $56.23 / $63.10	Professional	26	$54.95	$56.23	$63.10
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $123.03 / $169.82	Professional	TC	$112.20	$123.03	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $208.93 / $323.59	Professional		$154.88	$208.93	$323.59
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 $102.33 / $144.54 / $218.78	Professional	TC	$102.33	$144.54	$218.78