Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $91.20 / $398.11	Facility	26	$63.10	$91.20	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $125.89 / $309.03	Professional		$83.18	$125.89	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $74.13 / $223.87	Professional	26	$51.29	$74.13	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $41.69 / $81.28	Professional	TC	$26.30	$41.69	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $93.33 / $165.96	Professional		$87.10	$93.33	$165.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $67.61 / $104.71	Professional	26	$52.48	$67.61	$104.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $97.72 / $151.36	Professional		$83.18	$97.72	$151.36
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $57.54 / $97.72	Professional	26	$48.98	$57.54	$97.72
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $41.69 / $57.54	Professional	TC	$34.67	$41.69	$57.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $63.10 / $89.13	Facility	26	$13.49	$63.10	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $112.20 / $190.55	Professional		$85.11	$112.20	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $72.44 / $123.03	Professional	26	$53.70	$72.44	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $39.81 / $81.28	Professional	TC	$26.92	$39.81	$81.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $147.91 / $190.55	Professional		$114.82	$147.91	$190.55
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $81.28 / $107.15	Professional	26	$63.10	$81.28	$107.15
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 $91.20 / $125.89 / $204.17	Professional		$91.20	$125.89	$204.17
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $74.13 / $117.49	Professional	26	$56.23	$74.13	$117.49
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $47.86 / $77.62	Professional	TC	$27.54	$47.86	$77.62
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $69.18 / $95.50	Professional	26	$66.07	$69.18	$95.50
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $83.18 / $398.11	Facility	26	$69.18	$83.18	$398.11
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $128.82 / $269.15	Professional		$85.11	$128.82	$269.15
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $77.62 / $162.18	Professional	26	$52.48	$77.62	$162.18
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $50.12 / $97.72	Professional	TC	$28.18	$50.12	$97.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $154.88 / $186.21	Professional		$104.71	$154.88	$186.21
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $54.95 / $61.66 / $61.66	Facility	26	$54.95	$61.66	$61.66
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $95.50 / $218.78	Professional		$18.20	$95.50	$218.78
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $56.23 / $61.66	Professional	26	$54.95	$56.23	$61.66
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $40.74 / $45.71	Professional	TC	$27.54	$40.74	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $100.00 / $169.82	Professional		$79.43	$100.00	$169.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $66.07 / $109.65	Professional	26	$50.12	$66.07	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $61.66	Professional	TC	$25.70	$37.15	$61.66