Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $79.43 / $141.25	Facility	26	$30.20	$79.43	$141.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $123.03 / $426.58	Professional		$83.18	$123.03	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $50.12 / $177.83	Professional	26	$23.99	$50.12	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $85.11 / $288.40	Professional	TC	$61.66	$85.11	$288.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $57.54	Professional		$57.54	$57.54	$57.54
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $46.77 / $61.66	Professional	26	$15.49	$46.77	$61.66
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	TC	$44.67	$44.67	$44.67
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $158.49 / $229.09	Professional		$125.89	$158.49	$229.09
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $44.67 / $64.57	Professional	26	$33.11	$44.67	$64.57
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $114.82 / $169.82	Professional	TC	$91.20	$114.82	$169.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $70.79 / $102.33	Facility	26	$15.14	$70.79	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $72.44 / $177.83	Professional		$45.71	$72.44	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $18.20 / $45.71	Professional	26	$13.18	$18.20	$45.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $52.48 / $128.82	Professional	TC	$33.11	$52.48	$128.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $173.78 / $229.09	Professional		$95.50	$173.78	$229.09
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $45.71 / $58.88	Professional	26	$23.44	$45.71	$58.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $131.83 / $169.82	Professional	TC	$72.44	$131.83	$169.82
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $128.82 / $208.93	Professional		$89.13	$128.82	$208.93
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $35.48 / $54.95	Professional	26	$25.70	$35.48	$54.95
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $95.50 / $154.88	Professional	TC	$63.10	$95.50	$154.88
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $35.48 / $38.90	Professional	26	$33.11	$35.48	$38.90
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $81.28 / $83.18	Professional	TC	$81.28	$81.28	$83.18
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $79.43 / $141.25	Facility	26	$30.20	$79.43	$141.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $144.54 / $416.87	Professional		$89.13	$144.54	$416.87
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $42.66 / $128.82	Professional	26	$23.99	$42.66	$128.82
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $102.33 / $288.40	Professional	TC	$64.57	$102.33	$288.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $223.87 / $245.47	Professional		$190.55	$223.87	$245.47
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $29.51 / $33.11	Facility	26	$29.51	$29.51	$33.11
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $131.83 / $407.38	Professional		$42.66	$131.83	$407.38
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $33.11 / $33.88	Professional	26	$29.51	$33.11	$33.88
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $97.72 / $107.15	Professional	TC	$72.44	$97.72	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $128.82 / $186.21	Professional		$72.44	$128.82	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $34.67 / $52.48	Professional	26	$18.62	$34.67	$52.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $95.50 / $138.04	Professional	TC	$52.48	$95.50	$138.04