Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.29 / $101.28 / $132.11	Professional		$73.29	$101.28	$132.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.09 / $17.30 / $25.12	Professional	26	$15.09	$17.30	$25.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.10 / $84.14 / $109.35	Professional	TC	$60.10	$84.14	$109.35
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $105.52 / $109.51 / $183.63	Professional		$105.52	$109.51	$183.63
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $18.75 / $19.46 / $36.02	Professional	26	$18.75	$19.46	$36.02
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $86.77 / $90.05 / $147.19	Professional	TC	$86.77	$90.05	$147.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.76 / $104.95 / $200.64	Professional		$65.76	$104.95	$200.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.39 / $23.29 / $36.22	Professional	26	$14.39	$23.29	$36.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.08 / $80.15 / $160.87	Professional	TC	$45.08	$80.15	$160.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $88.83 / $142.36 / $171.59	Professional		$88.83	$142.36	$171.59
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.61 / $24.76 / $38.90	Professional	26	$20.61	$24.76	$38.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $103.83 / $129.31 / $184.21	Professional	TC	$103.83	$129.31	$184.21
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.78 / $35.78 / $35.78	Professional	26	$35.78	$35.78	$35.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $77.42 / $106.52 / $196.11	Professional		$77.42	$106.52	$196.11
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $16.17 / $18.86 / $47.42	Professional	26	$16.17	$18.86	$47.42
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $58.40 / $88.08 / $170.44	Professional	TC	$58.40	$88.08	$170.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.01 / $92.10 / $187.76	Professional		$22.01	$92.10	$187.76
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $66.00 / $104.95 / $190.05	Professional		$66.00	$104.95	$190.05
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.52 / $23.16 / $37.42	Professional	26	$14.52	$23.16	$37.42
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $45.78 / $81.86 / $151.13	Professional	TC	$45.78	$81.86	$151.13
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $55.52 / $112.11 / $122.29	Professional		$55.52	$112.11	$122.29
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $18.27 / $18.95 / $19.62	Professional	26	$18.27	$18.95	$19.62
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $36.08 / $93.26 / $102.66	Professional	TC	$36.08	$93.26	$102.66
United Facility/Professional Professional Modifier Low / Median / High Price $61.94 / $109.19 / $185.14	Professional		$61.94	$109.19	$185.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $21.17 / $35.86	Professional	26	$17.17	$21.17	$35.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.45 / $90.94 / $153.21	Professional	TC	$49.45	$90.94	$153.21