Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $104.71 / $151.36	Facility	26	$45.71	$104.71	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $107.15 / $263.03	Professional		$79.43	$107.15	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $67.61 / $173.78	Professional	TC	$48.98	$67.61	$173.78
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $109.65 / $109.65	Professional		$104.71	$109.65	$109.65
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $67.61 / $218.78	Professional	TC	$64.57	$67.61	$218.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $45.71 / $64.57	Facility	26	$9.77	$45.71	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $154.88 / $257.04	Professional		$85.11	$154.88	$257.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $102.33 / $186.21	Professional	TC	$52.48	$102.33	$186.21
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $147.91 / $186.21	Professional		$114.82	$147.91	$186.21
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $95.50 / $120.23	Professional	TC	$75.86	$95.50	$120.23
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $151.36 / $288.40	Professional		$114.82	$151.36	$288.40
Geisinger Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $112.20 / $190.55	Professional	TC	$70.79	$112.20	$190.55
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $104.71 / $144.54	Facility	26	$45.71	$104.71	$144.54
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $125.89 / $309.03	Professional		$89.13	$125.89	$309.03
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $81.28 / $199.53	Professional	TC	$54.95	$81.28	$199.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $151.36 / $263.03	Professional		$44.67	$151.36	$263.03
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $44.67 / $44.67	Facility	26	$38.90	$44.67	$44.67
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $218.78	Professional		$100.00	$128.82	$218.78
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $67.61 / $154.88	Professional	TC	$64.57	$67.61	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $125.89 / $213.80	Professional		$89.13	$125.89	$213.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $75.86 / $144.54	Professional	TC	$52.48	$75.86	$144.54