Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.32 / $29.81 / $71.42	Facility	26	$22.32	$29.81	$71.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.12 / $126.20 / $159.49	Professional		$98.12	$126.20	$159.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.12 / $104.58 / $132.38	Professional	TC	$78.12	$104.58	$132.38
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $133.76 / $138.81 / $221.86	Professional		$133.76	$138.81	$221.86
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $110.61 / $114.78 / $184.85	Professional	TC	$110.61	$114.78	$184.85
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.26 / $26.26 / $26.26	Facility	26	$26.26	$26.26	$26.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.95 / $138.94 / $245.88	Professional		$95.95	$138.94	$245.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.23 / $112.43 / $203.21	Professional	TC	$72.23	$112.43	$203.21
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $124.77 / $180.43 / $217.51	Professional		$124.77	$180.43	$217.51
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $132.38 / $164.80 / $234.70	Professional	TC	$132.38	$164.80	$234.70
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $22.32 / $41.74 / $72.98	Facility	26	$22.32	$41.74	$72.98
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $115.05 / $135.02 / $254.05	Professional		$115.05	$135.02	$254.05
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $92.51 / $113.03 / $212.35	Professional	TC	$92.51	$113.03	$212.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.22 / $134.31 / $252.35	Professional		$34.22	$134.31	$252.35
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $15.99 / $26.26 / $26.26	Facility	26	$15.99	$26.26	$26.26
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $97.22 / $138.44 / $228.74	Professional		$97.22	$138.44	$228.74
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $79.75 / $111.88 / $190.97	Professional	TC	$79.75	$111.88	$190.97
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $22.59 / $22.59 / $26.50	Facility	26	$22.59	$22.59	$26.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $101.00 / $135.44 / $147.63	Professional		$101.00	$135.44	$147.63
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $74.50 / $112.85 / $124.24	Professional	TC	$74.50	$112.85	$124.24
United Facility/Professional Professional Modifier Low / Median / High Price $97.03 / $134.65 / $230.93	Professional		$97.03	$134.65	$230.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.11 / $112.92 / $190.94	Professional	TC	$82.11	$112.92	$190.94