Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.03 / $109.49 / $109.49	Facility	26	$92.03	$109.49	$109.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.81 / $416.94 / $1,322.67	Professional		$312.81	$416.94	$1,322.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $92.03 / $110.37 / $252.05	Professional	26	$92.03	$110.37	$252.05
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $150.02 / $283.67 / $326.69	Professional	52	$150.02	$283.67	$326.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $199.37 / $235.69 / $410.83	Professional	TC	$199.37	$235.69	$410.83
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $328.20 / $340.58 / $340.58	Professional		$328.20	$340.58	$340.58
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $102.53 / $165.00 / $208.35	Professional	26	$102.53	$165.00	$208.35
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $225.66 / $346.46 / $409.09	Professional	TC	$225.66	$346.46	$409.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.52 / $419.37 / $669.43	Professional		$316.52	$419.37	$669.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.40 / $141.54 / $214.40	Professional	26	$106.40	$141.54	$214.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $205.75 / $284.13 / $477.03	Professional	TC	$205.75	$284.13	$477.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $398.44 / $527.72 / $546.49	Professional		$398.44	$527.72	$546.49
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $116.94 / $153.94 / $156.34	Professional	26	$116.94	$153.94	$156.34
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $281.51 / $373.77 / $390.15	Professional	TC	$281.51	$373.77	$390.15
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $109.49 / $109.49 / $109.49	Facility	26	$109.49	$109.49	$109.49
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $327.72 / $477.39 / $1,024.31	Professional		$327.72	$477.39	$1,024.31
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $96.13 / $145.40 / $268.14	Professional	26	$96.13	$145.40	$268.14
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $150.02 / $283.67 / $326.69	Professional	52	$150.02	$283.67	$326.69
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $206.93 / $290.01 / $598.27	Professional	TC	$206.93	$290.01	$598.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $283.89 / $1,005.80	Professional		$3.00	$283.89	$1,005.80
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $316.52 / $424.09 / $688.21	Professional		$316.52	$424.09	$688.21
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $110.78 / $143.69 / $238.15	Professional	26	$110.78	$143.69	$238.15
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $205.75 / $300.29 / $481.04	Professional	TC	$205.75	$300.29	$481.04
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $100.73 / $100.73 / $108.50	Facility	26	$100.73	$100.73	$108.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $285.50 / $350.49 / $379.56	Professional		$285.50	$350.49	$379.56
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $97.71 / $101.22 / $108.50	Professional	26	$97.71	$101.22	$108.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $177.00 / $249.75 / $274.93	Professional	TC	$177.00	$249.75	$274.93
United Facility/Professional Professional Modifier Low / Median / High Price $291.64 / $411.09 / $677.44	Professional		$291.64	$411.09	$677.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $103.16 / $128.37 / $211.39	Professional	26	$103.16	$128.37	$211.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $200.64 / $293.52 / $472.45	Professional	TC	$200.64	$293.52	$472.45