Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $39.81 / $97.72	Facility	26	$24.55	$39.81	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $380.19	Professional		$114.82	$162.18	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $26.92 / $77.62	Professional	26	$20.89	$26.92	$77.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $112.20 / $275.42	Professional	TC	$91.20	$112.20	$275.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $95.50 / $120.23	Professional		$91.20	$95.50	$120.23
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $20.42 / $24.55	Professional	26	$18.20	$20.42	$24.55
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $229.09	Professional		$104.71	$123.03	$229.09
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $23.99 / $46.77	Professional	26	$20.42	$23.99	$46.77
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $97.72 / $181.97	Professional	TC	$83.18	$97.72	$181.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $38.02	Facility	26	$5.62	$26.30	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $169.82 / $275.42	Professional		$117.49	$169.82	$275.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $26.30 / $46.77	Professional	26	$20.42	$26.30	$46.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $147.91 / $234.42	Professional	TC	$95.50	$147.91	$234.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $213.80	Professional		$128.82	$169.82	$213.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $32.36 / $40.74	Professional	26	$27.54	$32.36	$40.74
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $138.04 / $181.97	Professional	TC	$120.23	$138.04	$181.97
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $162.18 / $269.15	Professional		$120.23	$162.18	$269.15
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $28.18 / $43.65	Professional	26	$20.42	$28.18	$43.65
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $138.04 / $234.42	Professional	TC	$97.72	$138.04	$234.42
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $30.90 / $446.68	Professional	26	$26.30	$30.90	$446.68
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $35.48 / $87.10	Facility	26	$24.55	$35.48	$87.10
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $186.21 / $363.08	Professional		$117.49	$186.21	$363.08
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $31.62 / $67.61	Professional	26	$21.88	$31.62	$67.61
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $151.36 / $288.40	Professional	TC	$93.33	$151.36	$288.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $181.97 / $275.42	Professional		$46.77	$181.97	$275.42
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $23.44 / $28.18	Facility	26	$23.44	$23.44	$28.18
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $75.86 / $213.80	Professional		$18.62	$75.86	$213.80
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $23.99 / $28.18	Professional	26	$22.91	$23.99	$28.18
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $95.50 / $186.21	Professional	TC	$93.33	$95.50	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $245.47	Professional		$112.20	$144.54	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $25.70 / $45.71	Professional	26	$19.50	$25.70	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $123.03 / $208.93	Professional	TC	$89.13	$123.03	$208.93