Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $21.88 / $338.84	Facility	26	$19.05	$21.88	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $89.13 / $363.08	Professional		$57.54	$89.13	$363.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $31.62 / $100.00	Professional	26	$16.98	$31.62	$100.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.84 / $54.95 / $245.47	Professional	50	$28.84	$54.95	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $45.71 / $85.11	Professional	TC	$38.02	$45.71	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $58.88 / $109.65	Professional		$52.48	$58.88	$109.65
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $26.30 / $30.90	Professional	26	$16.98	$26.30	$30.90
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $74.13 / $104.71	Professional		$57.54	$74.13	$104.71
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $23.99 / $34.67	Professional	26	$18.20	$23.99	$34.67
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $114.82 / $147.91 / $213.80	Professional	50	$114.82	$147.91	$213.80
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $50.12 / $70.79	Professional	TC	$39.81	$50.12	$70.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $4.37 / $20.42 / $29.51	Facility	26	$4.37	$20.42	$29.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $74.13 / $138.04	Professional		$54.95	$74.13	$138.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $23.44 / $40.74	Professional	26	$16.98	$23.44	$40.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $51.29 / $93.33	Professional	TC	$38.02	$51.29	$93.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $100.00 / $131.83	Professional		$67.61	$100.00	$131.83
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $27.54 / $37.15	Professional	26	$18.62	$27.54	$37.15
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $72.44 / $95.50	Professional	TC	$48.98	$72.44	$95.50
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $120.23	Professional		$52.48	$70.79	$120.23
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $21.38 / $35.48	Professional	26	$17.38	$21.38	$35.48
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $50.12 / $85.11	Professional	TC	$34.67	$50.12	$85.11
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $67.61 / $100.00	Professional		$20.89	$67.61	$100.00
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.30 / $70.79	Professional	26	$19.95	$26.30	$70.79
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $123.03 / $138.04 / $181.97	Professional	50	$123.03	$138.04	$181.97
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $26.30 / $57.54	Facility	26	$19.05	$26.30	$57.54
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $87.10 / $251.19	Professional		$57.54	$87.10	$251.19
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $26.92 / $75.86	Professional	26	$16.98	$26.92	$75.86
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $28.84 / $54.95 / $245.47	Professional	50	$28.84	$54.95	$245.47
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $53.70 / $104.71	Professional	TC	$39.81	$53.70	$104.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $97.72 / $125.89	Professional		$64.57	$97.72	$125.89
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $16.22 / $17.38 / $17.38	Facility	26	$16.22	$17.38	$17.38
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $27.54 / $64.57	Professional		$9.12	$27.54	$64.57
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $17.38 / $18.20	Professional	26	$16.98	$17.38	$18.20
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $41.69 / $45.71	Professional	TC	$40.74	$41.69	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $117.49	Professional		$52.48	$67.61	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $21.38 / $35.48	Professional	26	$15.85	$21.38	$35.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $47.86 / $81.28	Professional	TC	$35.48	$47.86	$81.28