Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $478.63 / $954.99	Facility		$169.82	$478.63	$954.99
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $141.25 / $165.96	Facility	26	$34.67	$141.25	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $131.83 / $407.38	Professional		$87.10	$131.83	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $169.82 / $575.44	Professional	26	$38.02	$169.82	$575.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $74.13 / $302.00	Professional	TC	$53.70	$74.13	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $57.54 / $74.13	Professional	26	$19.95	$57.54	$74.13
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $70.79 / $70.79	Professional	TC	$70.79	$70.79	$70.79
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $120.23 / $199.53	Professional		$114.82	$120.23	$199.53
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $41.69 / $70.79	Professional	26	$39.81	$41.69	$70.79
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $77.62 / $131.83	Professional	TC	$75.86	$77.62	$131.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $208.93	Facility		$128.82	$128.82	$208.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $63.10 / $91.20	Facility	26	$13.49	$63.10	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $79.43 / $173.78	Professional		$54.95	$79.43	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $33.11 / $72.44	Professional	26	$19.50	$33.11	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $42.66 / $95.50	Professional	TC	$30.20	$42.66	$95.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $165.96 / $218.78	Professional		$91.20	$165.96	$218.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $56.23 / $72.44	Professional	26	$28.84	$56.23	$72.44
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $112.20 / $147.91	Professional	TC	$61.66	$112.20	$147.91
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $141.25 / $251.19	Professional		$100.00	$141.25	$251.19
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $61.66 / $100.00	Professional	26	$45.71	$61.66	$100.00
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $89.13 / $138.04	Professional	TC	$43.65	$89.13	$138.04
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Facility		$831.76	$831.76	$831.76
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $128.82 / $141.25	Professional		$109.65	$128.82	$141.25
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $43.65 / $69.18	Professional	26	$40.74	$43.65	$69.18
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $467.74 / $954.99	Facility		$169.82	$467.74	$954.99
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $97.72 / $165.96	Facility	26	$57.54	$97.72	$165.96
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $134.90 / $331.13	Professional		$87.10	$134.90	$331.13
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $91.20 / $501.19	Professional	26	$33.11	$91.20	$501.19
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $81.28 / $208.93	Professional	TC	$53.70	$81.28	$208.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $213.80 / $251.19	Professional		$181.97	$213.80	$251.19
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $114.82 / $346.74	Professional		$38.02	$114.82	$346.74
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $40.74 / $66.07	Professional	26	$39.81	$40.74	$66.07
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $72.44 / $81.28	Professional	TC	$48.98	$72.44	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $120.23 / $190.55	Professional		$66.07	$120.23	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $43.65 / $69.18	Professional	26	$24.55	$43.65	$69.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $77.62 / $125.89	Professional	TC	$41.69	$77.62	$125.89