Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $47.86 / $128.82	Facility		$23.99	$47.86	$128.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.75 / $16.22 / $27.54	Facility	26	$5.75	$16.22	$27.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $38.90 / $100.00	Professional		$20.89	$38.90	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.25 / $16.22 / $42.66	Professional	26	$5.25	$16.22	$42.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $29.51 / $74.13	Professional	TC	$16.22	$29.51	$74.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $3.09 / $9.33 / $11.48	Professional	26	$3.09	$9.33	$11.48
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $48.98 / $77.62	Professional		$32.36	$48.98	$77.62
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.23 / $16.60	Professional	26	$6.61	$10.23	$16.60
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $69.18	Professional	TC	$25.70	$37.15	$69.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $43.65 / $74.13	Facility		$43.65	$43.65	$74.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $1.62 / $7.59 / $10.72	Facility	26	$1.62	$7.59	$10.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $27.54 / $56.23	Professional		$15.14	$27.54	$56.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.16 / $4.79 / $10.72	Professional	26	$3.16	$4.79	$10.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $23.44 / $46.77	Professional	TC	$11.75	$23.44	$46.77
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $44.67 / $58.88	Professional		$24.55	$44.67	$58.88
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $9.33 / $12.30	Professional	26	$5.01	$9.33	$12.30
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $35.48 / $46.77	Professional	TC	$19.95	$35.48	$46.77
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $79.43	Professional		$33.11	$46.77	$79.43
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $8.51 / $14.79	Professional	26	$6.76	$8.51	$14.79
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $38.90 / $69.18	Professional	TC	$25.12	$38.90	$69.18
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Facility		$199.53	$199.53	$199.53
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $34.67 / $36.31	Professional		$29.51	$34.67	$36.31
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $7.24 / $10.96	Professional	26	$6.76	$7.24	$10.96
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $47.86 / $128.82	Facility		$23.99	$47.86	$128.82
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $5.75 / $16.22 / $27.54	Facility	26	$5.75	$16.22	$27.54
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $38.90 / $87.10	Professional		$21.88	$38.90	$87.10
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $11.48 / $34.67	Professional	26	$5.01	$11.48	$34.67
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $30.90 / $69.18	Professional	TC	$18.20	$30.90	$69.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $57.54 / $63.10	Professional		$46.77	$57.54	$63.10
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $6.31 / $16.60 / $47.86	Professional		$6.31	$16.60	$47.86
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $6.61 / $10.96	Professional	26	$6.61	$6.61	$10.96
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $24.55 / $36.31	Professional	TC	$23.99	$24.55	$36.31
United Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $29.51 / $53.70	Professional		$16.60	$29.51	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.89 / $7.08 / $11.48	Professional	26	$3.89	$7.08	$11.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $23.44 / $43.65	Professional	TC	$13.49	$23.44	$43.65