Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $123.33 / $295.58 / $348.78	Facility	26	$123.33	$295.58	$348.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.88 / $123.73 / $191.19	Professional		$85.88	$123.73	$191.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.89 / $76.75 / $211.73	Professional	26	$54.89	$76.75	$211.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.78 / $38.02 / $77.93	Professional	TC	$20.78	$38.02	$77.93
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $115.19 / $119.54 / $194.56	Professional		$115.19	$119.54	$194.56
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $86.58 / $89.85 / $146.38	Professional	26	$86.58	$89.85	$146.38
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $28.61 / $29.69 / $48.17	Professional	TC	$28.61	$29.69	$48.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $133.12 / $133.12 / $133.12	Facility	26	$133.12	$133.12	$133.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.33 / $80.72 / $176.09	Professional		$54.33	$80.72	$176.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.99 / $53.27 / $114.66	Professional	26	$39.99	$53.27	$114.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $28.84 / $64.81	Professional	TC	$13.49	$28.84	$64.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $72.05 / $164.27 / $215.95	Professional		$72.05	$164.27	$215.95
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $52.87 / $119.63 / $156.51	Professional	26	$52.87	$119.63	$156.51
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.19 / $44.63 / $59.42	Professional	TC	$19.19	$44.63	$59.42
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.16 / $143.16 / $143.16	Professional		$143.16	$143.16	$143.16
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.43 / $91.03 / $139.13	Professional	26	$88.43	$91.03	$139.13
Highmark BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.49 / $48.49 / $48.49	Professional	TC	$48.49	$48.49	$48.49
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $123.33 / $348.78 / $348.78	Facility	26	$123.33	$348.78	$348.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $88.13 / $137.69 / $302.79	Professional		$88.13	$137.69	$302.79
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $67.45 / $92.73 / $227.94	Professional	26	$67.45	$92.73	$227.94
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $20.78 / $40.75 / $78.67	Professional	TC	$20.78	$40.75	$78.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.78 / $113.60 / $199.20	Professional		$30.78	$113.60	$199.20
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $133.12 / $133.12 / $133.12	Facility	26	$133.12	$133.12	$133.12
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $54.33 / $89.70 / $189.09	Professional		$54.33	$89.70	$189.09
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $40.60 / $64.95 / $124.51	Professional	26	$40.60	$64.95	$124.51
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $30.44 / $65.91	Professional	TC	$13.49	$30.44	$65.91
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $99.25 / $111.00 / $142.93	Professional		$99.25	$111.00	$142.93
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $73.05 / $84.45 / $88.16	Professional	26	$73.05	$84.45	$88.16
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.01 / $26.55 / $54.77	Professional	TC	$26.01	$26.55	$54.77
United Facility/Professional Professional Modifier Low / Median / High Price $62.94 / $114.43 / $187.23	Professional		$62.94	$114.43	$187.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.17 / $89.39 / $149.47	Professional	26	$49.17	$89.39	$149.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.02 / $26.29 / $49.39	Professional	TC	$15.02	$26.29	$49.39