Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $35.48 / $147.91	Facility	26	$22.91	$35.48	$147.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $63.10 / $138.04	Professional		$39.81	$63.10	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $23.99 / $69.18	Professional	26	$18.20	$23.99	$69.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $34.67 / $66.07	Professional	TC	$18.20	$34.67	$66.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $51.29 / $64.57	Professional		$48.98	$51.29	$64.57
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $21.38 / $21.38	Professional	26	$21.38	$21.38	$21.38
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $56.23 / $83.18	Professional		$47.86	$56.23	$83.18
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $20.89 / $36.31	Professional	26	$17.78	$20.89	$36.31
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $33.88 / $47.86	Professional	TC	$26.92	$33.88	$47.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.90 / $22.91 / $33.11	Facility	26	$4.90	$22.91	$33.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $58.88 / $107.15	Professional		$43.65	$58.88	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.92 / $45.71	Professional	26	$19.50	$26.92	$45.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $31.62 / $66.07	Professional	TC	$18.62	$31.62	$66.07
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $87.10 / $112.20	Professional		$66.07	$87.10	$112.20
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.20 / $39.81	Professional	26	$22.91	$30.20	$39.81
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $56.23 / $72.44	Professional	TC	$42.66	$56.23	$72.44
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $67.61 / $107.15	Professional		$44.67	$67.61	$107.15
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $27.54 / $47.86	Professional	26	$20.42	$27.54	$47.86
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $38.90 / $64.57	Professional	TC	$19.50	$38.90	$64.57
Highmark BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $181.97 / $181.97 / $181.97	Facility	26	$181.97	$181.97	$181.97
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Professional		$47.86	$47.86	$47.86
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $26.92 / $26.92	Professional	26	$26.92	$26.92	$26.92
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $33.88 / $147.91	Facility	26	$25.12	$33.88	$147.91
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $67.61 / $141.25	Professional		$39.81	$67.61	$141.25
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $26.92 / $61.66	Professional	26	$19.05	$26.92	$61.66
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $40.74 / $83.18	Professional	TC	$18.62	$40.74	$83.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $107.15	Professional		$52.48	$72.44	$107.15
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $19.95 / $30.90	Facility	26	$19.95	$19.95	$30.90
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $41.69 / $75.86	Professional		$17.38	$41.69	$75.86
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.95 / $20.42	Professional	26	$19.50	$19.95	$20.42
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $34.67 / $38.02	Professional	TC	$33.88	$34.67	$38.02
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $53.70 / $91.20	Professional		$40.74	$53.70	$91.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $24.55 / $39.81	Professional	26	$18.62	$24.55	$39.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $30.90 / $52.48	Professional	TC	$19.50	$30.90	$52.48