Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $165.96 / $165.96	Facility	26	$100.00	$165.96	$165.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $117.49 / $512.86	Professional		$79.43	$117.49	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $43.65 / $257.04	Professional	26	$30.20	$43.65	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $83.18 / $302.00	Professional	TC	$53.70	$83.18	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Professional	26	$77.62	$77.62	$77.62
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $154.88 / $309.03	Professional		$144.54	$154.88	$309.03
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $53.70 / $173.78	Professional	26	$41.69	$53.70	$173.78
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $107.15 / $177.83	Professional	TC	$102.33	$107.15	$177.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $58.88 / $85.11	Facility	26	$12.59	$58.88	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $117.49 / $223.87	Professional		$67.61	$117.49	$223.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $36.31 / $89.13	Professional	26	$19.95	$36.31	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $77.62 / $134.90	Professional	TC	$42.66	$77.62	$134.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $204.17 / $263.03	Professional		$112.20	$204.17	$263.03
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $57.54 / $74.13	Professional	26	$29.51	$57.54	$74.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $144.54 / $190.55	Professional	TC	$81.28	$144.54	$190.55
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $186.21 / $346.74	Professional		$138.04	$186.21	$346.74
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $69.18 / $123.03	Professional	26	$46.77	$69.18	$123.03
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $125.89 / $213.80	Professional	TC	$67.61	$125.89	$213.80
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $43.65 / $43.65	Professional	26	$42.66	$43.65	$43.65
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $165.96 / $165.96	Facility	26	$100.00	$165.96	$165.96
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $131.83 / $562.34	Professional		$97.72	$131.83	$562.34
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $46.77 / $218.78	Professional	26	$30.90	$46.77	$218.78
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $93.33 / $398.11	Professional	TC	$67.61	$93.33	$398.11
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $457.09	Professional		$218.78	$288.40	$457.09
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $134.90 / $398.11	Professional		$57.54	$134.90	$398.11
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $41.69 / $112.20	Professional	26	$39.81	$41.69	$112.20
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $93.33 / $104.71	Professional	TC	$87.10	$93.33	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $134.90 / $223.87	Professional		$75.86	$134.90	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $42.66 / $75.86	Professional	26	$24.55	$42.66	$75.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $87.10 / $151.36	Professional	TC	$51.29	$87.10	$151.36