Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.03 / $55.31 / $134.50	Facility	26	$42.03	$55.31	$134.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.20 / $206.14 / $297.02	Professional		$173.20	$206.14	$297.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.69 / $164.67 / $250.40	Professional	TC	$136.69	$164.67	$250.40
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $196.82 / $204.25 / $412.99	Professional		$196.82	$204.25	$412.99
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $153.84 / $159.63 / $330.97	Professional	TC	$153.84	$159.63	$330.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.71 / $48.71 / $48.71	Facility	26	$48.71	$48.71	$48.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.19 / $269.16 / $432.18	Professional		$164.19	$269.16	$432.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.77 / $215.83 / $349.64	Professional	TC	$130.77	$215.83	$349.64
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $285.54 / $285.54 / $318.70	Professional		$285.54	$285.54	$318.70
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $229.13 / $229.13 / $255.62	Professional	TC	$229.13	$229.13	$255.62
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $42.03 / $78.59 / $137.44	Facility	26	$42.03	$78.59	$137.44
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $183.51 / $213.05 / $841.55	Professional		$183.51	$213.05	$841.55
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $144.83 / $171.01 / $631.51	Professional	TC	$144.83	$171.01	$631.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.01 / $219.23 / $307.70	Professional		$60.01	$219.23	$307.70
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $48.71 / $48.71 / $48.71	Facility	26	$48.71	$48.71	$48.71
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $177.51 / $278.14 / $434.02	Professional		$177.51	$278.14	$434.02
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $145.13 / $221.40 / $350.91	Professional	TC	$145.13	$221.40	$350.91
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $42.21 / $42.21 / $50.00	Facility	26	$42.21	$42.21	$50.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $195.69 / $198.99 / $250.50	Professional		$195.69	$198.99	$250.50
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $153.49 / $156.78 / $200.50	Professional	TC	$153.49	$156.78	$200.50
United Facility/Professional Professional Modifier Low / Median / High Price $196.42 / $250.98 / $402.65	Professional		$196.42	$250.98	$402.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $155.56 / $207.41 / $323.68	Professional	TC	$155.56	$207.41	$323.68