Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $181.97 / $380.19	Facility	26	$125.89	$181.97	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $831.76 / $2,951.21	Professional		$588.84	$831.76	$2,951.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $208.93 / $562.34	Professional	26	$117.49	$208.93	$562.34
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $213.80 / $257.04 / $1,258.93	Professional	52	$213.80	$257.04	$1,258.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $660.69 / $1,479.11	Professional	TC	$478.63	$660.69	$1,479.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $616.60 / $676.08	Professional		$575.44	$616.60	$676.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $128.82 / $208.93	Professional	26	$112.20	$128.82	$208.93
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $467.74 / $575.44	Professional	TC	$457.09	$467.74	$575.44
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $794.33 / $1,288.25	Professional		$676.08	$794.33	$1,288.25
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $169.82 / $263.03	Professional	26	$128.82	$169.82	$263.03
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $537.03 / $645.65 / $1,023.29	Professional	TC	$537.03	$645.65	$1,023.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $138.04 / $199.53	Facility	26	$29.51	$138.04	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $912.01 / $1,445.44	Professional		$602.56	$912.01	$1,445.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $186.21 / $302.00	Professional	26	$114.82	$186.21	$302.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $741.31 / $1,174.90	Professional	TC	$478.63	$741.31	$1,174.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $512.86 / $851.14 / $1,479.11	Professional		$512.86	$851.14	$1,479.11
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $186.21 / $251.19	Professional	26	$125.89	$186.21	$251.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $630.96 / $912.01 / $1,202.26	Professional	TC	$630.96	$912.01	$1,202.26
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $645.65 / $1,202.26	Professional		$630.96	$645.65	$1,202.26
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $144.54 / $239.88	Professional	26	$144.54	$144.54	$239.88
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $489.78 / $501.19 / $977.24	Professional	TC	$489.78	$501.19	$977.24
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $724.44 / $912.01	Professional		$125.89	$724.44	$912.01
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $134.90 / $173.78 / $208.93	Professional	26	$134.90	$173.78	$208.93
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $562.34 / $588.84 / $602.56	Professional	TC	$562.34	$588.84	$602.56
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $181.97 / $380.19	Facility	26	$125.89	$181.97	$380.19
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $912.01 / $1,737.80	Professional		$630.96	$912.01	$1,737.80
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $190.55 / $398.11	Professional	26	$123.03	$190.55	$398.11
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $199.53 / $218.78 / $1,258.93	Professional	52	$199.53	$218.78	$1,258.93
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $501.19 / $741.31 / $1,348.96	Professional	TC	$501.19	$741.31	$1,348.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $831.76 / $1,380.38	Professional		$229.09	$831.76	$1,380.38
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $120.23 / $120.23 / $213.80	Facility	26	$120.23	$120.23	$213.80
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $407.38 / $660.69	Professional		$309.03	$407.38	$660.69
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $120.23 / $213.80	Professional	26	$117.49	$120.23	$213.80
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $478.63 / $489.78 / $630.96	Professional	TC	$478.63	$489.78	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $794.33 / $1,258.93	Professional		$562.34	$794.33	$1,258.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $158.49 / $251.19	Professional	26	$109.65	$158.49	$251.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $457.09 / $616.60 / $1,023.29	Professional	TC	$457.09	$616.60	$1,023.29