Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $30.20 / $34.67	Professional	26	$26.30	$30.20	$34.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $91.20 / $109.65	Professional		$91.20	$91.20	$109.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $24.55 / $29.51	Professional	26	$24.55	$24.55	$29.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $66.07 / $79.43	Professional	TC	$66.07	$66.07	$79.43
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $70.79 / $100.00	Professional		$56.23	$70.79	$100.00
Geisinger Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $19.95 / $28.18	Professional	26	$19.95	$19.95	$28.18
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $51.29 / $70.79	Professional	TC	$40.74	$51.29	$70.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $112.20 / $147.91	Professional		$0.60	$112.20	$147.91
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $19.95 / $21.88	Facility	26	$19.95	$19.95	$21.88
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $58.88 / $117.49	Professional		$15.85	$58.88	$117.49
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $19.95 / $21.88	Professional	26	$19.95	$19.95	$21.88
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $51.29 / $56.23	Professional	TC	$50.12	$51.29	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $95.50 / $162.18	Professional		$66.07	$95.50	$162.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $22.91 / $38.02	Professional	26	$18.20	$22.91	$38.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $67.61 / $134.90	Professional	TC	$46.77	$67.61	$134.90