Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $144.54 / $181.97	Facility	26	$47.86	$144.54	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $275.42 / $562.34	Professional		$208.93	$275.42	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $56.23 / $186.21	Professional	26	$41.69	$56.23	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $229.09 / $436.52	Professional	TC	$169.82	$229.09	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $208.93 / $263.03	Professional		$190.55	$208.93	$263.03
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $36.31 / $64.57	Professional	26	$34.67	$36.31	$64.57
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $208.93 / $208.93	Professional	TC	$208.93	$208.93	$208.93
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $257.04 / $489.78	Professional		$245.47	$257.04	$489.78
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $46.77 / $97.72	Professional	26	$44.67	$46.77	$97.72
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $208.93 / $407.38	Professional	TC	$194.98	$208.93	$407.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $51.29 / $72.44	Facility	26	$10.96	$51.29	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $346.74 / $549.54	Professional		$245.47	$346.74	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $57.54 / $91.20	Professional	26	$42.66	$57.54	$91.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $288.40 / $467.74	Professional	TC	$204.17	$288.40	$467.74
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $371.54 / $478.63	Professional		$323.59	$371.54	$478.63
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $64.57 / $77.62	Professional	26	$53.70	$64.57	$77.62
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $309.03 / $398.11	Professional	TC	$269.15	$309.03	$398.11
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $331.13 / $436.52	Professional		$194.98	$331.13	$436.52
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $60.26 / $93.33	Professional	26	$46.77	$60.26	$93.33
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $269.15 / $363.08	Professional	TC	$147.91	$269.15	$363.08
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $57.54 / $61.66	Professional	26	$52.48	$57.54	$61.66
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $89.13 / $181.97	Facility	26	$47.86	$89.13	$181.97
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $316.23 / $660.69	Professional		$218.78	$316.23	$660.69
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $63.10 / $141.25	Professional	26	$42.66	$63.10	$141.25
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $257.04 / $549.54	Professional	TC	$173.78	$257.04	$549.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $398.11 / $660.69	Professional		$91.20	$398.11	$660.69
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $56.23	Facility	26	$44.67	$44.67	$56.23
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $257.04 / $676.08	Professional		$93.33	$257.04	$676.08
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $44.67 / $45.71	Professional	26	$43.65	$44.67	$45.71
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $213.80 / $234.42	Professional	TC	$208.93	$213.80	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $288.40 / $512.86	Professional		$223.87	$288.40	$512.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $51.29 / $91.20	Professional	26	$40.74	$51.29	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $245.47 / $426.58	Professional	TC	$190.55	$245.47	$426.58