Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $45.71 / $45.71	Facility	26	$45.71	$45.71	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $87.10 / $173.78	Professional		$74.13	$87.10	$173.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $45.71 / $91.20	Professional	26	$39.81	$45.71	$91.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $42.66 / $81.28	Professional	TC	$35.48	$42.66	$81.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $85.11	Professional		$66.07	$81.28	$85.11
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $41.69 / $41.69	Professional	26	$41.69	$41.69	$41.69
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $87.10 / $147.91	Professional		$85.11	$87.10	$147.91
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $45.71 / $83.18	Professional	26	$43.65	$45.71	$83.18
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $42.66 / $72.44	Professional	TC	$38.02	$42.66	$72.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $50.12 / $70.79	Facility	26	$10.72	$50.12	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $100.00 / $199.53	Professional		$67.61	$100.00	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $56.23 / $97.72	Professional	26	$40.74	$56.23	$97.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $44.67 / $97.72	Professional	TC	$24.55	$44.67	$97.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $138.04 / $186.21	Professional		$93.33	$138.04	$186.21
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $66.07 / $89.13	Professional	26	$44.67	$66.07	$89.13
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 $66.07 / $102.33 / $169.82	Professional		$66.07	$102.33	$169.82
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $53.70 / $89.13	Professional	26	$43.65	$53.70	$89.13
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $48.98 / $85.11	Professional	TC	$18.62	$48.98	$85.11
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $72.44 / $83.18	Professional	26	$64.57	$72.44	$83.18
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $45.71 / $45.71	Facility	26	$45.71	$45.71	$45.71
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $95.50 / $213.80	Professional		$77.62	$95.50	$213.80
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $50.12 / $114.82	Professional	26	$40.74	$50.12	$114.82
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $47.86 / $102.33	Professional	TC	$36.31	$47.86	$102.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $134.90 / $173.78	Professional		$74.13	$134.90	$173.78
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $43.65 / $47.86	Facility	26	$43.65	$43.65	$47.86
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $51.29 / $257.04	Professional		$13.80	$51.29	$257.04
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $43.65 / $47.86	Professional	26	$42.66	$43.65	$47.86
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $40.74 / $45.71	Professional	TC	$30.20	$40.74	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $89.13 / $158.49	Professional		$63.10	$89.13	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $52.48 / $87.10	Professional	26	$38.02	$52.48	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $42.66 / $75.86	Professional	TC	$26.30	$42.66	$75.86