Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $72.44 / $302.00	Facility	26	$46.77	$72.44	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $97.72 / $263.03	Professional		$67.61	$97.72	$263.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $57.54 / $162.18	Professional	26	$38.90	$57.54	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $38.90 / $75.86	Professional	TC	$22.91	$38.90	$75.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $141.25	Professional		$70.79	$100.00	$141.25
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $50.12 / $57.54	Professional	26	$38.02	$50.12	$57.54
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $79.43 / $120.23	Professional		$67.61	$79.43	$120.23
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $41.69 / $72.44	Professional	26	$35.48	$41.69	$72.44
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $36.31 / $52.48	Professional	TC	$30.90	$36.31	$52.48
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 $67.61 / $89.13 / $154.88	Professional		$67.61	$89.13	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $54.95 / $91.20	Professional	26	$38.90	$54.95	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $36.31 / $72.44	Professional	TC	$23.44	$36.31	$72.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $158.49	Professional		$93.33	$120.23	$158.49
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 $45.71 / $60.26 / $79.43	Professional	TC	$45.71	$60.26	$79.43
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $102.33 / $165.96	Professional		$74.13	$102.33	$165.96
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $54.95 / $93.33	Professional	26	$41.69	$54.95	$93.33
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $42.66 / $70.79	Professional	TC	$24.55	$42.66	$70.79
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $501.19 / $501.19	Professional		$501.19	$501.19	$501.19
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $54.95 / $70.79	Professional	26	$53.70	$54.95	$70.79
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $69.18 / $302.00	Facility	26	$46.77	$69.18	$302.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $104.71 / $223.87	Professional		$67.61	$104.71	$223.87
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 $23.99 / $45.71 / $91.20	Professional	TC	$23.99	$45.71	$91.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $120.23 / $151.36	Professional		$87.10	$120.23	$151.36
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $48.98 / $48.98	Facility	26	$40.74	$48.98	$48.98
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $30.90 / $131.83	Professional		$22.39	$30.90	$131.83
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $40.74 / $48.98	Professional	26	$39.81	$40.74	$48.98
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $37.15 / $41.69	Professional	TC	$23.99	$37.15	$41.69
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $81.28 / $134.90	Professional		$63.10	$81.28	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $48.98 / $81.28	Professional	26	$37.15	$48.98	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.88 / $56.23	Professional	TC	$23.44	$33.88	$56.23