Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $190.55 / $190.55	Facility	26	$67.61	$190.55	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $363.08 / $691.83	Professional		$302.00	$363.08	$691.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $39.81 / $107.15	Professional	26	$30.90	$39.81	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $323.59 / $602.56	Professional	TC	$269.15	$323.59	$602.56
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $407.38 / $724.44	Professional		$389.05	$407.38	$724.44
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $48.98 / $81.28	Professional	26	$47.86	$48.98	$81.28
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $354.81 / $645.65	Professional	TC	$338.84	$354.81	$645.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.48 / $53.70 / $75.86	Facility	26	$11.48	$53.70	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $316.23 / $676.08	Professional		$190.55	$316.23	$676.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $30.90 / $69.18	Professional	26	$22.39	$30.90	$69.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $275.42 / $616.60	Professional	TC	$165.96	$275.42	$616.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $549.54 / $707.95	Professional		$302.00	$549.54	$707.95
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $64.57 / $85.11	Professional	26	$33.88	$64.57	$85.11
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $478.63 / $630.96	Professional	TC	$269.15	$478.63	$630.96
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $436.52 / $812.83	Professional		$363.08	$436.52	$812.83
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $53.70 / $95.50	Professional	26	$44.67	$53.70	$95.50
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $380.19 / $707.95	Professional	TC	$316.23	$380.19	$707.95
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 $47.86 / $48.98 / $50.12	Professional	26	$47.86	$48.98	$50.12
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $190.55 / $190.55	Facility	26	$67.61	$190.55	$190.55
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $389.05 / $1,122.02	Professional		$309.03	$389.05	$1,122.02
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $41.69 / $120.23	Professional	26	$32.36	$41.69	$120.23
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $354.81 / $1,000.00	Professional	TC	$269.15	$354.81	$1,000.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $758.58 / $1,071.52	Professional		$602.56	$758.58	$1,071.52
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $309.03 / $407.38	Professional		$87.10	$309.03	$407.38
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $46.77 / $48.98	Professional	26	$46.77	$46.77	$48.98
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $346.74 / $389.05	Professional	TC	$346.74	$346.74	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $426.58 / $660.69	Professional		$234.42	$426.58	$660.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $50.12 / $81.28	Professional	26	$27.54	$50.12	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $371.54 / $588.84	Professional	TC	$204.17	$371.54	$588.84