Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.39 / $59.56 / $160.82	Facility	26	$52.39	$59.56	$160.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.70 / $336.05 / $871.91	Professional		$288.70	$336.05	$871.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.09 / $54.15 / $144.84	Professional	26	$47.09	$54.15	$144.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $238.81 / $281.89 / $1,477.69	Professional	TC	$238.81	$281.89	$1,477.69
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $302.41 / $548.79 / $659.83	Professional		$302.41	$548.79	$659.83
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $55.45 / $93.59 / $109.61	Professional	26	$55.45	$93.59	$109.61
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $246.96 / $455.66 / $550.23	Professional	TC	$246.96	$455.66	$550.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.78 / $63.78 / $63.78	Facility	26	$63.78	$63.78	$63.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $254.53 / $418.76 / $654.60	Professional		$254.53	$418.76	$654.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $68.00 / $108.10	Professional	26	$39.97	$68.00	$108.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.78 / $352.49 / $546.50	Professional	TC	$208.78	$352.49	$546.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $440.64 / $440.64 / $490.78	Professional		$440.64	$440.64	$490.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $72.66 / $72.66 / $81.19	Professional	26	$72.66	$72.66	$81.19
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $367.98 / $367.98 / $409.61	Professional	TC	$367.98	$367.98	$409.61
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.94 / $338.94 / $338.94	Professional		$338.94	$338.94	$338.94
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.72 / $53.68 / $64.02	Professional	26	$52.72	$53.68	$64.02
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $52.39 / $78.98 / $173.28	Facility	26	$52.39	$78.98	$173.28
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $288.70 / $378.27 / $871.91	Professional		$288.70	$378.27	$871.91
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $49.03 / $56.39 / $144.84	Professional	26	$49.03	$56.39	$144.84
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $238.81 / $317.00 / $837.21	Professional	TC	$238.81	$317.00	$837.21
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $63.78 / $63.78 / $63.78	Facility	26	$63.78	$63.78	$63.78
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $262.69 / $424.13 / $663.25	Professional		$262.69	$424.13	$663.25
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.53 / $70.56 / $109.85	Professional	26	$40.53	$70.56	$109.85
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $225.37 / $355.46 / $563.41	Professional	TC	$225.37	$355.46	$563.41
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $51.66 / $55.15 / $55.15	Facility	26	$51.66	$55.15	$55.15
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $306.33 / $311.83 / $339.70	Professional		$306.33	$311.83	$339.70
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $51.66 / $55.15 / $57.11	Professional	26	$51.66	$55.15	$57.11
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $251.15 / $256.69 / $282.58	Professional	TC	$251.15	$256.69	$282.58
United Facility/Professional Professional Modifier Low / Median / High Price $310.52 / $392.37 / $636.58	Professional		$310.52	$392.37	$636.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.01 / $70.68 / $111.34	Professional	26	$53.01	$70.68	$111.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.52 / $335.85 / $540.87	Professional	TC	$257.52	$335.85	$540.87