Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.34 / $36.29 / $87.49	Facility	26	$27.34	$36.29	$87.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.38 / $88.66 / $119.88	Professional		$74.38	$88.66	$119.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.76 / $62.48 / $90.23	Professional	TC	$50.76	$62.48	$90.23
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $85.36 / $88.58 / $164.31	Professional		$85.36	$88.58	$164.31
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $57.84 / $60.03 / $108.70	Professional	TC	$57.84	$60.03	$108.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.62 / $31.62 / $31.62	Facility	26	$31.62	$31.62	$31.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.48 / $115.48 / $192.86	Professional		$71.48	$115.48	$192.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.79 / $80.23 / $147.03	Professional	TC	$48.79	$80.23	$147.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $95.48 / $123.33 / $149.58	Professional		$95.48	$123.33	$149.58
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $69.30 / $86.14 / $122.61	Professional	TC	$69.30	$86.14	$122.61
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $27.34 / $50.88 / $89.40	Facility	26	$27.34	$50.88	$89.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $74.38 / $95.79 / $155.84	Professional		$74.38	$95.79	$155.84
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $50.76 / $68.97 / $113.87	Professional	TC	$50.76	$68.97	$113.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.97 / $96.90 / $159.08	Professional		$31.97	$96.90	$159.08
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $19.14 / $31.62 / $31.62	Facility	26	$19.14	$31.62	$31.62
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $71.48 / $114.50 / $192.86	Professional		$71.48	$114.50	$192.86
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.32 / $79.39 / $144.49	Professional	TC	$49.32	$79.39	$144.49
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $27.84 / $27.84 / $31.50	Facility	26	$27.84	$27.84	$31.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $86.64 / $93.64	Professional		$79.00	$86.64	$93.64
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $47.50 / $58.80 / $64.73	Professional	TC	$47.50	$58.80	$64.73
United Facility/Professional Professional Modifier Low / Median / High Price $79.61 / $107.05 / $183.45	Professional		$79.61	$107.05	$183.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.91 / $75.89 / $126.64	Professional	TC	$56.91	$75.89	$126.64