Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $275.42 / $398.11 / $794.33	Facility	26	$275.42	$398.11	$794.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $977.24 / $1,174.90 / $3,235.94	Professional		$977.24	$1,174.90	$3,235.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $275.42 / $407.38 / $1,288.25	Professional	26	$275.42	$407.38	$1,288.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $707.95 / $831.76 / $1,548.82	Professional	TC	$707.95	$831.76	$1,548.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $870.96	Professional		$870.96	$870.96	$870.96
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $316.23 / $512.86	Professional	26	$269.15	$316.23	$512.86
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,621.81 / $2,137.96	Professional		$954.99	$1,621.81	$2,137.96
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $288.40 / $489.78 / $676.08	Professional	26	$288.40	$489.78	$676.08
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $676.08 / $1,122.02 / $1,479.11	Professional	TC	$676.08	$1,122.02	$1,479.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,412.54 / $1,995.26	Professional		$1,071.52	$1,412.54	$1,995.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $309.03 / $426.58 / $588.84	Professional	26	$309.03	$426.58	$588.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $758.58 / $954.99 / $1,445.44	Professional	TC	$758.58	$954.99	$1,445.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,737.80	Professional		$1,584.89	$1,584.89	$1,737.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $426.58 / $426.58 / $501.19	Professional	26	$426.58	$426.58	$501.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $1,148.15 / $1,148.15 / $1,258.93	Professional	TC	$1,148.15	$1,148.15	$1,258.93
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,412.54 / $2,238.72	Professional		$1,047.13	$1,412.54	$2,238.72
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $323.59 / $426.58 / $645.65	Professional	26	$323.59	$426.58	$645.65
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $741.31 / $1,000.00 / $1,584.89	Professional	TC	$741.31	$1,000.00	$1,584.89
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $275.42 / $398.11 / $794.33	Facility	26	$275.42	$398.11	$794.33
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,412.54 / $2,884.03	Professional		$1,000.00	$1,412.54	$2,884.03
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $275.42 / $416.87 / $912.01	Professional	26	$275.42	$416.87	$912.01
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $724.44 / $977.24 / $1,862.09	Professional	TC	$724.44	$977.24	$1,862.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,288.25 / $2,884.03	Professional		$1,230.27	$1,288.25	$2,884.03
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $281.84 / $281.84 / $302.00	Facility	26	$281.84	$281.84	$302.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $891.25 / $1,023.29	Professional		$691.83	$891.25	$1,023.29
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $269.15 / $288.40 / $302.00	Professional	26	$269.15	$288.40	$302.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $660.69 / $707.95 / $794.33	Professional	TC	$660.69	$707.95	$794.33
United Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,348.96 / $2,187.76	Professional		$1,047.13	$1,348.96	$2,187.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $295.12 / $407.38 / $616.60	Professional	26	$295.12	$407.38	$616.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $741.31 / $954.99 / $1,548.82	Professional	TC	$741.31	$954.99	$1,548.82