Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $213.80 / $575.44	Facility	26	$173.78	$213.80	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $371.54 / $1,258.93	Professional		$269.15	$371.54	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $169.82 / $229.09 / $549.54	Professional	26	$169.82	$229.09	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $117.49 / $218.78	Professional	TC	$93.33	$117.49	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $281.84 / $416.87	Professional		$257.04	$281.84	$416.87
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $239.88 / $316.23	Professional	26	$165.96	$239.88	$316.23
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $371.54 / $549.54	Professional		$281.84	$371.54	$549.54
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $239.88 / $354.81	Professional	26	$181.97	$239.88	$354.81
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $134.90 / $199.53	Professional	TC	$95.50	$134.90	$199.53
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $208.93 / $295.12	Facility	26	$44.67	$208.93	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $389.05 / $645.65	Professional		$263.03	$389.05	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $239.88 / $407.38	Professional	26	$173.78	$239.88	$407.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $144.54 / $245.47	Professional	TC	$93.33	$144.54	$245.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $457.09 / $616.60	Professional		$309.03	$457.09	$616.60
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $281.84 / $380.19	Professional	26	$190.55	$281.84	$380.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $177.83 / $229.09	Professional	TC	$120.23	$177.83	$229.09
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $338.84 / $588.84	Professional		$288.40	$338.84	$588.84
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $181.97 / $213.80 / $363.08	Professional	26	$181.97	$213.80	$363.08
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $128.82 / $229.09	Professional	TC	$102.33	$128.82	$229.09
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $323.59 / $416.87	Professional		$302.00	$323.59	$416.87
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $199.53 / $218.78 / $309.03	Professional	26	$199.53	$218.78	$309.03
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $218.78 / $363.08	Facility	26	$173.78	$218.78	$363.08
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $389.05 / $794.33	Professional		$275.42	$389.05	$794.33
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $173.78 / $239.88 / $501.19	Professional	26	$173.78	$239.88	$501.19
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $134.90 / $257.04	Professional	TC	$97.72	$134.90	$257.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $446.68 / $602.56	Professional		$323.59	$446.68	$602.56
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $165.96 / $181.97	Facility	26	$165.96	$165.96	$181.97
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $199.53 / $281.84	Professional		$43.65	$199.53	$281.84
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $165.96 / $177.83 / $186.21	Professional	26	$165.96	$177.83	$186.21
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $100.00 / $107.15	Professional	TC	$95.50	$100.00	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $346.74 / $588.84	Professional		$263.03	$346.74	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $162.18 / $218.78 / $363.08	Professional	26	$162.18	$218.78	$363.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $128.82 / $218.78	Professional	TC	$97.72	$128.82	$218.78