Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $40.74 / $85.11	Facility	26	$23.99	$40.74	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $141.25 / $354.81	Professional		$46.77	$141.25	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $30.90 / $67.61	Professional	26	$19.95	$30.90	$67.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $114.82 / $218.78	Professional	TC	$91.20	$114.82	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $93.33 / $112.20	Professional		$74.13	$93.33	$112.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $20.89 / $33.88	Professional	26	$17.78	$20.89	$33.88
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $77.62 / $77.62	Professional	TC	$77.62	$77.62	$77.62
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $123.03 / $229.09	Professional		$117.49	$123.03	$229.09
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $23.99 / $44.67	Professional	26	$22.91	$23.99	$44.67
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $97.72 / $186.21	Professional	TC	$95.50	$97.72	$186.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $26.30 / $37.15	Facility	26	$5.62	$26.30	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $173.78 / $269.15	Professional		$117.49	$173.78	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $23.99 / $44.67	Professional	26	$16.22	$23.99	$44.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $151.36 / $234.42	Professional	TC	$95.50	$151.36	$234.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $165.96 / $213.80	Professional		$144.54	$165.96	$213.80
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $31.62 / $38.90	Professional	26	$26.92	$31.62	$38.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $154.88 / $204.17	Professional	TC	$117.49	$154.88	$204.17
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $154.88 / $234.42	Professional		$109.65	$154.88	$234.42
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $25.12 / $38.90	Professional	26	$15.49	$25.12	$38.90
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $125.89 / $194.98	Professional	TC	$91.20	$125.89	$194.98
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $162.18	Professional		$138.04	$138.04	$162.18
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $25.70 / $30.20	Professional	26	$23.99	$25.70	$30.20
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $36.31 / $77.62	Facility	26	$23.99	$36.31	$77.62
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $162.18 / $346.74	Professional		$112.20	$162.18	$346.74
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $30.90 / $63.10	Professional	26	$19.95	$30.90	$63.10
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $134.90 / $275.42	Professional	TC	$95.50	$134.90	$275.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $223.87 / $338.84	Professional		$151.36	$223.87	$338.84
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $21.88 / $22.39	Facility	26	$21.88	$21.88	$22.39
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $52.48 / $141.25	Professional		$26.30	$52.48	$141.25
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $22.39 / $23.44	Professional	26	$21.88	$22.39	$23.44
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $95.50 / $112.20	Professional	TC	$93.33	$95.50	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $144.54 / $245.47	Professional		$109.65	$144.54	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $25.12 / $44.67	Professional	26	$15.85	$25.12	$44.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $123.03 / $213.80	Professional	TC	$91.20	$123.03	$213.80