Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.82 / $101.27 / $101.27	Facility	26	$85.82	$101.27	$101.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.76 / $57.68 / $95.93	Professional		$40.76	$57.68	$95.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.98 / $20.05 / $27.89	Professional	26	$15.98	$20.05	$27.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.78 / $34.90 / $66.70	Professional	TC	$24.78	$34.90	$66.70
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $81.34 / $84.41 / $120.41	Professional		$81.34	$84.41	$120.41
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $24.77 / $32.27 / $61.63	Professional	26	$24.77	$32.27	$61.63
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $39.47 / $58.71 / $80.23	Professional	TC	$39.47	$58.71	$80.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.25 / $40.25 / $40.25	Facility	26	$40.25	$40.25	$40.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.09 / $42.05 / $91.02	Professional		$26.09	$42.05	$91.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.65 / $14.90 / $35.11	Professional	26	$11.65	$14.90	$35.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.83 / $26.69 / $56.18	Professional	TC	$13.83	$26.69	$56.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $53.16 / $122.68 / $162.78	Professional		$53.16	$122.68	$162.78
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.21 / $34.40 / $45.24	Professional	26	$15.21	$34.40	$45.24
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.95 / $88.28 / $117.54	Professional	TC	$37.95	$88.28	$117.54
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.82 / $26.26 / $28.89	Professional	26	$24.82	$26.26	$28.89
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $101.27 / $101.27 / $101.27	Facility	26	$101.27	$101.27	$101.27
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $47.46 / $58.81 / $303.60	Professional		$47.46	$58.81	$303.60
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $18.93 / $23.29 / $101.27	Professional	26	$18.93	$23.29	$101.27
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $27.21 / $38.43 / $202.33	Professional	TC	$27.21	$38.43	$202.33
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $34.68 / $79.89 / $141.60	Professional		$34.68	$79.89	$141.60
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $40.25 / $40.25 / $40.25	Facility	26	$40.25	$40.25	$40.25
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $26.09 / $46.12 / $95.57	Professional		$26.09	$46.12	$95.57
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.68 / $22.06 / $36.93	Professional	26	$11.68	$22.06	$36.93
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.83 / $28.09 / $64.05	Professional	TC	$13.83	$28.09	$64.05
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $61.85 / $72.66 / $79.42	Professional		$61.85	$72.66	$79.42
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $24.41 / $25.01 / $28.00	Professional	26	$24.41	$25.01	$28.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.86 / $48.65 / $53.94	Professional	TC	$34.86	$48.65	$53.94
United Facility/Professional Professional Modifier Low / Median / High Price $30.57 / $66.42 / $103.99	Professional		$30.57	$66.42	$103.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.21 / $25.83 / $38.46	Professional	26	$14.21	$25.83	$38.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.32 / $40.59 / $64.58	Professional	TC	$22.32	$40.59	$64.58