Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $112.20 / $302.00	Facility	26	$46.77	$112.20	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $95.50 / $204.17	Professional		$72.44	$95.50	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $50.12 / $190.55	Professional	26	$38.02	$50.12	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $42.66 / $81.28	Professional	TC	$25.70	$42.66	$81.28
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $83.18 / $125.89	Professional		$70.79	$83.18	$125.89
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $41.69 / $75.86	Professional	26	$35.48	$41.69	$75.86
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $40.74 / $57.54	Professional	TC	$34.67	$40.74	$57.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $45.71 / $66.07	Facility	26	$10.00	$45.71	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $95.50 / $162.18	Professional		$72.44	$95.50	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $56.23 / $91.20	Professional	26	$39.81	$56.23	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $39.81 / $81.28	Professional	TC	$26.30	$39.81	$81.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $128.82 / $165.96	Professional		$97.72	$128.82	$165.96
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $60.26 / $79.43	Professional	26	$46.77	$60.26	$79.43
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $67.61 / $87.10	Professional	TC	$51.29	$67.61	$87.10
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $173.78	Professional		$77.62	$107.15	$173.78
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $54.95 / $100.00	Professional	26	$41.69	$54.95	$100.00
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $46.77 / $77.62	Professional	TC	$26.92	$46.77	$77.62
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	26	$54.95	$54.95	$54.95
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $61.66 / $302.00	Facility	26	$46.77	$61.66	$302.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $218.78	Professional		$72.44	$102.33	$218.78
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $57.54 / $128.82	Professional	26	$38.90	$57.54	$128.82
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $48.98 / $104.71	Professional	TC	$26.92	$48.98	$104.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $158.49	Professional		$93.33	$131.83	$158.49
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $40.74 / $52.48	Facility	26	$40.74	$40.74	$52.48
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $44.67 / $309.03	Professional		$11.75	$44.67	$309.03
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $40.74 / $42.66	Professional	26	$39.81	$40.74	$42.66
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $41.69 / $45.71	Professional	TC	$40.74	$41.69	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $85.11 / $144.54	Professional		$66.07	$85.11	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $50.12 / $83.18	Professional	26	$37.15	$50.12	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $63.10	Professional	TC	$25.70	$37.15	$63.10