Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $102.33 / $102.33	Facility	26	$58.88	$102.33	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $57.54 / $162.18	Professional		$41.69	$57.54	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $20.42 / $77.62	Professional	26	$15.14	$20.42	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $37.15 / $109.65	Professional	TC	$24.55	$37.15	$109.65
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $85.11 / $128.82	Professional		$81.28	$85.11	$128.82
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $32.36 / $61.66	Professional	26	$24.55	$32.36	$61.66
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $58.88 / $85.11	Professional	TC	$39.81	$58.88	$85.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.03 / $28.18 / $39.81	Facility	26	$6.03	$28.18	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $42.66 / $91.20	Professional		$26.30	$42.66	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $15.85 / $36.31	Professional	26	$11.75	$15.85	$36.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $26.92 / $58.88	Professional	TC	$14.45	$26.92	$58.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $114.82 / $151.36	Professional		$63.10	$114.82	$151.36
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $33.88 / $44.67	Professional	26	$17.78	$33.88	$44.67
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $81.28 / $104.71	Professional	TC	$44.67	$81.28	$104.71
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $93.33 / $134.90	Professional		$52.48	$93.33	$134.90
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $30.90 / $54.95	Professional	26	$25.12	$30.90	$54.95
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $58.88 / $93.33	Professional	TC	$25.70	$58.88	$93.33
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $25.70 / $34.67	Professional	26	$24.55	$25.70	$34.67
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $102.33 / $102.33	Facility	26	$58.88	$102.33	$102.33
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $64.57 / $194.98	Professional		$41.69	$64.57	$194.98
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $22.91 / $77.62	Professional	26	$16.98	$22.91	$77.62
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $41.69 / $120.23	Professional	TC	$26.92	$41.69	$120.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $114.82 / $158.49	Professional		$89.13	$114.82	$158.49
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $63.10 / $114.82	Professional		$7.41	$63.10	$114.82
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $24.55 / $28.18	Professional	26	$23.99	$24.55	$28.18
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $47.86 / $53.70	Professional	TC	$34.67	$47.86	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $66.07 / $104.71	Professional		$30.90	$66.07	$104.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $25.70 / $42.66	Professional	26	$14.13	$25.70	$42.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $40.74 / $66.07	Professional	TC	$22.39	$40.74	$66.07