Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.94 / $102.59 / $102.59	Facility	26	$86.94	$102.59	$102.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.16 / $56.10 / $97.12	Professional		$45.16	$56.10	$97.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.64 / $20.32 / $44.53	Professional	26	$16.64	$20.32	$44.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.60 / $35.78 / $71.59	Professional	TC	$26.60	$35.78	$71.59
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $80.70 / $83.75 / $131.51	Professional		$80.70	$83.75	$131.51
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $25.09 / $26.04 / $48.45	Professional	26	$25.09	$26.04	$48.45
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $53.18 / $57.72 / $83.06	Professional	TC	$53.18	$57.72	$83.06
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.39 / $28.39 / $28.39	Facility	26	$28.39	$28.39	$28.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.24 / $42.40 / $92.87	Professional		$24.24	$42.40	$92.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $15.14 / $34.54	Professional	26	$11.70	$15.14	$34.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.21 / $26.24 / $57.92	Professional	TC	$12.21	$26.24	$57.92
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.73 / $121.69 / $161.47	Professional		$52.73	$121.69	$161.47
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.42 / $34.90 / $45.90	Professional	26	$15.42	$34.90	$45.90
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.32 / $86.79 / $115.58	Professional	TC	$37.32	$86.79	$115.58
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.93 / $25.93 / $25.93	Professional		$25.93	$25.93	$25.93
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.42 / $29.29 / $41.28	Professional	26	$26.42	$29.29	$41.28
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $102.59 / $102.59 / $102.59	Facility	26	$102.59	$102.59	$102.59
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $47.46 / $58.81 / $297.07	Professional		$47.46	$58.81	$297.07
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $19.17 / $22.71 / $102.59	Professional	26	$19.17	$22.71	$102.59
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $28.52 / $37.78 / $194.48	Professional	TC	$28.52	$37.78	$194.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.03 / $77.66 / $140.50	Professional		$35.03	$77.66	$140.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $28.39 / $28.39 / $28.39	Facility	26	$28.39	$28.39	$28.39
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $24.24 / $43.69 / $95.65	Professional		$24.24	$43.69	$95.65
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.70 / $21.75 / $37.22	Professional	26	$11.70	$21.75	$37.22
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $12.40 / $27.85 / $63.36	Professional	TC	$12.40	$27.85	$63.36
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $54.58 / $71.09 / $77.68	Professional		$54.58	$71.09	$77.68
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $24.72 / $25.34 / $26.99	Professional	26	$24.72	$25.34	$26.99
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $27.59 / $46.76 / $51.85	Professional	TC	$27.59	$46.76	$51.85
United Facility/Professional Professional Modifier Low / Median / High Price $29.37 / $69.12 / $113.09	Professional		$29.37	$69.12	$113.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.22 / $26.51 / $39.77	Professional	26	$14.22	$26.51	$39.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $42.61 / $63.91	Professional	TC	$23.44	$42.61	$63.91