Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.46 / $51.23 / $123.07	Facility	26	$38.46	$51.23	$123.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.81 / $104.75 / $140.74	Professional		$90.81	$104.75	$140.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.18 / $69.37 / $100.62	Professional	TC	$56.18	$69.37	$100.62
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $105.06 / $109.02 / $162.22	Professional		$105.06	$109.02	$162.22
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $65.16 / $78.38 / $258.58	Professional	TC	$65.16	$78.38	$258.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.47 / $45.47 / $45.47	Facility	26	$45.47	$45.47	$45.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.47 / $151.65 / $258.14	Professional		$86.47	$151.65	$258.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.89 / $102.04 / $189.25	Professional	TC	$53.89	$102.04	$189.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $126.02 / $150.41 / $221.06	Professional		$126.02	$150.41	$221.06
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $77.98 / $97.09 / $138.29	Professional	TC	$77.98	$97.09	$138.29
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $38.46 / $71.92 / $125.76	Facility	26	$38.46	$71.92	$125.76
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $90.93 / $110.45 / $226.06	Professional		$90.93	$110.45	$226.06
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $57.58 / $72.00 / $172.74	Professional	TC	$57.58	$72.00	$172.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.86 / $97.80 / $247.20	Professional		$40.86	$97.80	$247.20
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $26.75 / $45.47 / $45.47	Facility	26	$26.75	$45.47	$45.47
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $86.47 / $150.72 / $250.57	Professional		$86.47	$150.72	$250.57
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $54.09 / $96.76 / $185.64	Professional	TC	$54.09	$96.76	$185.64
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $39.15 / $39.15 / $44.50	Facility	26	$39.15	$39.15	$44.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $104.41 / $105.86 / $200.50	Professional		$104.41	$105.86	$200.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $65.26 / $66.70 / $156.00	Professional	TC	$65.26	$66.70	$156.00
United Facility/Professional Professional Modifier Low / Median / High Price $92.00 / $130.62 / $209.73	Professional		$92.00	$130.62	$209.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.64 / $79.95 / $141.94	Professional	TC	$53.64	$79.95	$141.94