Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $245.47 / $371.54	Facility	26	$93.33	$245.47	$371.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $891.25 / $2,454.71	Professional		$758.58	$891.25	$2,454.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $100.00 / $363.08	Professional	26	$81.28	$100.00	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $794.33 / $1,513.56	Professional	TC	$645.65	$794.33	$1,513.56
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $138.04 / $147.91	Professional	26	$100.00	$138.04	$147.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $794.33 / $1,479.11	Professional		$776.25	$794.33	$1,479.11
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $100.00 / $169.82	Professional	26	$95.50	$100.00	$169.82
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $676.08 / $691.83 / $1,318.26	Professional	TC	$676.08	$691.83	$1,318.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $1,047.13 / $1,659.59	Professional		$660.69	$1,047.13	$1,659.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $117.49 / $190.55	Professional	26	$69.18	$117.49	$190.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $588.84 / $954.99 / $1,479.11	Professional	TC	$588.84	$954.99	$1,479.11
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,348.96	Professional		$1,148.15	$1,148.15	$1,348.96
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $128.82 / $151.36	Professional	26	$128.82	$128.82	$151.36
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,000.00 / $1,000.00 / $1,202.26	Professional	TC	$1,000.00	$1,000.00	$1,202.26
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $741.31 / $1,023.29 / $1,445.44	Professional		$741.31	$1,023.29	$1,445.44
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $128.82 / $165.96	Professional	26	$100.00	$128.82	$165.96
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $891.25 / $1,288.25	Professional	TC	$645.65	$891.25	$1,288.25
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $134.90 / $446.68	Professional	26	$95.50	$134.90	$446.68
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $181.97 / $354.81	Facility	26	$93.33	$181.97	$354.81
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $758.58 / $1,000.00 / $2,454.71	Professional		$758.58	$1,000.00	$2,454.71
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $114.82 / $316.23	Professional	26	$83.18	$114.82	$316.23
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $676.08 / $891.25 / $2,041.74	Professional	TC	$676.08	$891.25	$2,041.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,202.26 / $1,445.44 / $1,905.46	Professional		$1,202.26	$1,445.44	$1,905.46
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $95.50 / $95.50 / $112.20	Facility	26	$95.50	$95.50	$112.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,000.00 / $1,071.52	Professional		$812.83	$1,000.00	$1,071.52
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $100.00 / $112.20	Professional	26	$93.33	$100.00	$112.20
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $707.95 / $776.25 / $870.96	Professional	TC	$707.95	$776.25	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $1,000.00 / $1,698.24	Professional		$812.83	$1,000.00	$1,698.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $114.82 / $190.55	Professional	26	$91.20	$114.82	$190.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $707.95 / $912.01 / $1,513.56	Professional	TC	$707.95	$912.01	$1,513.56