Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $100.00 / $100.00	Facility	26	$60.26	$100.00	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $75.86	Professional		$45.71	$53.70	$75.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.95 / $28.84	Professional	26	$14.13	$19.95	$28.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $33.11 / $50.12	Professional	TC	$28.84	$33.11	$50.12
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $91.20 / $117.49	Professional		$64.57	$91.20	$117.49
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $34.67 / $44.67	Professional	26	$24.55	$34.67	$44.67
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $56.23 / $72.44	Professional	TC	$39.81	$56.23	$72.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.13 / $38.02 / $54.95	Facility	26	$8.13	$38.02	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $46.77 / $97.72	Professional		$29.51	$46.77	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $14.45 / $34.67	Professional	26	$10.47	$14.45	$34.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $30.90 / $64.57	Professional	TC	$18.62	$30.90	$64.57
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $89.13 / $117.49	Professional		$47.86	$89.13	$117.49
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $33.88 / $44.67	Professional	26	$17.38	$33.88	$44.67
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $54.95 / $70.79	Professional	TC	$30.20	$54.95	$70.79
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $69.18 / $109.65	Professional		$54.95	$69.18	$109.65
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.92 / $40.74	Professional	26	$19.95	$26.92	$40.74
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $42.66 / $69.18	Professional	TC	$35.48	$42.66	$69.18
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $100.00 / $100.00	Facility	26	$60.26	$100.00	$100.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $57.54 / $186.21	Professional		$46.77	$57.54	$186.21
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $19.95 / $61.66	Professional	26	$14.13	$19.95	$61.66
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $37.15 / $123.03	Professional	TC	$30.90	$37.15	$123.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $112.20 / $144.54	Professional		$95.50	$112.20	$144.54
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $64.57 / $131.83	Professional		$11.75	$64.57	$131.83
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $24.55 / $25.12	Professional	26	$22.91	$24.55	$25.12
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $41.69 / $45.71	Professional	TC	$39.81	$41.69	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $69.18 / $109.65	Professional		$39.81	$69.18	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $26.30 / $42.66	Professional	26	$14.13	$26.30	$42.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $44.67 / $66.07	Professional	TC	$24.55	$44.67	$66.07