Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.43 / $174.75 / $350.50	Facility	26	$100.43	$174.75	$350.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $735.22 / $862.63 / $1,181.35	Professional		$735.22	$862.63	$1,181.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $630.50 / $773.52 / $1,073.83	Professional	TC	$630.50	$773.52	$1,073.83
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $900.89 / $934.89 / $1,498.79	Professional		$900.89	$934.89	$1,498.79
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $801.59 / $831.84 / $1,338.12	Professional	TC	$801.59	$831.84	$1,338.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.28 / $114.28 / $114.28	Facility	26	$114.28	$114.28	$114.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $347.80 / $878.72 / $1,665.31	Professional		$347.80	$878.72	$1,665.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $272.76 / $766.11 / $1,486.80	Professional	TC	$272.76	$766.11	$1,486.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $637.51 / $1,169.03 / $1,483.36	Professional		$637.51	$1,169.03	$1,483.36
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $958.98 / $1,194.78 / $1,327.34	Professional	TC	$958.98	$1,194.78	$1,327.34
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $100.43 / $187.80 / $396.70	Facility	26	$100.43	$187.80	$396.70
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $735.22 / $940.81 / $4,041.01	Professional		$735.22	$940.81	$4,041.01
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $630.50 / $850.45 / $3,644.27	Professional	TC	$630.50	$850.45	$3,644.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $151.34 / $1,288.89 / $1,977.50	Professional		$151.34	$1,288.89	$1,977.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $114.28 / $114.28 / $114.28	Facility	26	$114.28	$114.28	$114.28
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $347.80 / $926.56 / $1,739.74	Professional		$347.80	$926.56	$1,739.74
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $272.76 / $790.61 / $1,558.48	Professional	TC	$272.76	$790.61	$1,558.48
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $98.08 / $98.08 / $115.00	Facility	26	$98.08	$98.08	$115.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $270.50 / $915.01 / $1,001.93	Professional		$270.50	$915.01	$1,001.93
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $155.50 / $816.92 / $899.28	Professional	TC	$155.50	$816.92	$899.28
United Facility/Professional Professional Modifier Low / Median / High Price $549.60 / $909.46 / $1,611.22	Professional		$549.60	$909.46	$1,611.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $594.39 / $820.47 / $1,406.16	Professional	TC	$594.39	$820.47	$1,406.16