Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $147.91 / $147.91	Facility	26	$51.29	$147.91	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $46.77 / $134.90	Professional		$37.15	$46.77	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $72.44 / $251.19	Professional	26	$26.92	$72.44	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.02 / $16.98 / $47.86	Professional	TC	$12.02	$16.98	$47.86
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $33.88 / $51.29	Professional	26	$33.88	$33.88	$51.29
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $57.54 / $95.50	Professional		$54.95	$57.54	$95.50
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.02 / $63.10	Professional	26	$36.31	$38.02	$63.10
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $19.05 / $32.36	Professional	TC	$18.62	$19.05	$32.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $41.69 / $58.88	Facility	26	$8.91	$41.69	$58.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $36.31 / $77.62	Professional		$25.70	$36.31	$77.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $23.99 / $51.29	Professional	26	$16.60	$23.99	$51.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $8.13 / $12.02 / $26.92	Professional	TC	$8.13	$12.02	$26.92
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $75.86 / $100.00	Professional		$40.74	$75.86	$100.00
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $50.12 / $66.07	Professional	26	$26.30	$50.12	$66.07
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $25.70 / $33.88	Professional	TC	$14.45	$25.70	$33.88
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $66.07 / $114.82	Professional		$43.65	$66.07	$114.82
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $44.67 / $75.86	Professional	26	$31.62	$44.67	$75.86
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $12.59 / $21.88 / $38.02	Professional	TC	$12.59	$21.88	$38.02
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.90 / $42.66	Professional	26	$36.31	$38.90	$42.66
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $147.91 / $147.91	Facility	26	$51.29	$147.91	$147.91
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $57.54 / $158.49	Professional		$40.74	$57.54	$158.49
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $45.71 / $147.91	Professional	26	$28.18	$45.71	$147.91
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $19.50 / $53.70	Professional	TC	$14.13	$19.50	$53.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $102.33 / $125.89	Professional		$81.28	$102.33	$125.89
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $57.54 / $190.55	Professional		$12.59	$57.54	$190.55
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $36.31 / $37.15	Professional	26	$36.31	$36.31	$37.15
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $18.20 / $20.42	Professional	TC	$17.78	$18.20	$20.42
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $56.23 / $85.11	Professional		$30.90	$56.23	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $38.90 / $63.10	Professional	26	$21.38	$38.90	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.77 / $16.98 / $30.20	Professional	TC	$9.77	$16.98	$30.20