Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $144.54 / $169.82	Facility	26	$36.31	$144.54	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $245.47 / $346.74	Professional		$162.18	$245.47	$346.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $38.90 / $426.58	Professional	26	$28.84	$38.90	$426.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $208.93 / $302.00	Professional	TC	$128.82	$208.93	$302.00
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $57.54 / $57.54	Professional	26	$57.54	$57.54	$57.54
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $354.81 / $537.03	Professional		$263.03	$354.81	$537.03
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $56.23 / $83.18	Professional	26	$40.74	$56.23	$83.18
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $275.42 / $467.74	Professional	TC	$218.78	$275.42	$467.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $46.77 / $66.07	Facility	26	$10.00	$46.77	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $177.83 / $363.08	Professional		$100.00	$177.83	$363.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $28.18 / $61.66	Professional	26	$19.05	$28.18	$61.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $141.25 / $288.40	Professional	TC	$75.86	$141.25	$288.40
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $371.54 / $478.63	Professional		$204.17	$371.54	$478.63
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $56.23 / $74.13	Professional	26	$29.51	$56.23	$74.13
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $309.03 / $407.38	Professional	TC	$173.78	$309.03	$407.38
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $269.15 / $436.52	Professional		$186.21	$269.15	$436.52
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $51.29 / $83.18	Professional	26	$41.69	$51.29	$83.18
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $223.87 / $363.08	Professional	TC	$144.54	$223.87	$363.08
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $43.65 / $72.44	Professional	26	$41.69	$43.65	$72.44
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $58.88 / $100.00 / $169.82	Facility	26	$58.88	$100.00	$169.82
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $263.03 / $676.08	Professional		$181.97	$263.03	$676.08
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $42.66 / $169.82	Professional	26	$28.84	$42.66	$169.82
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $223.87 / $645.65	Professional	TC	$151.36	$223.87	$645.65
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $478.63 / $512.86	Professional		$407.38	$478.63	$512.86
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $181.97 / $309.03	Professional		$30.90	$181.97	$309.03
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $41.69 / $48.98	Professional	26	$40.74	$41.69	$48.98
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $245.47 / $269.15	Professional	TC	$162.18	$245.47	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $295.12 / $467.74	Professional		$151.36	$295.12	$467.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $45.71 / $70.79	Professional	26	$25.12	$45.71	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $275.42 / $398.11	Professional	TC	$120.23	$275.42	$398.11