Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.12 / $133.47 / $133.47	Facility	26	$113.12	$133.47	$133.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.07 / $104.52 / $534.28	Professional		$83.07	$104.52	$534.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.03 / $27.61 / $54.07	Professional	26	$22.03	$27.61	$54.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.47 / $66.02 / $204.02	Professional	TC	$45.47	$66.02	$204.02
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $105.76 / $109.75 / $184.48	Professional		$105.76	$109.75	$184.48
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $32.34 / $33.56 / $55.85	Professional	26	$32.34	$33.56	$55.85
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $73.42 / $76.19 / $125.31	Professional	TC	$73.42	$76.19	$125.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.17 / $69.17 / $69.17	Facility	26	$69.17	$69.17	$69.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.80 / $115.95 / $252.35	Professional		$50.80	$115.95	$252.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.53 / $31.91 / $75.34	Professional	26	$15.53	$31.91	$75.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.63 / $82.93 / $173.81	Professional	TC	$34.63	$82.93	$173.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $68.86 / $158.88 / $210.29	Professional		$68.86	$158.88	$210.29
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $19.63 / $44.37 / $58.14	Professional	26	$19.63	$44.37	$58.14
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $49.24 / $114.60 / $152.30	Professional	TC	$49.24	$114.60	$152.30
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $133.47 / $133.47 / $133.47	Facility	26	$133.47	$133.47	$133.47
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $83.07 / $124.71 / $534.28	Professional		$83.07	$124.71	$534.28
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $25.05 / $34.03 / $133.47	Professional	26	$25.05	$34.03	$133.47
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $57.31 / $83.06 / $315.95	Professional	TC	$57.31	$83.06	$315.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $31.74 / $99.12 / $194.19	Professional		$31.74	$99.12	$194.19
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $69.17 / $69.17 / $69.17	Facility	26	$69.17	$69.17	$69.17
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $50.68 / $115.95 / $254.29	Professional		$50.68	$115.95	$254.29
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.25 / $32.97 / $75.20	Professional	26	$15.25	$32.97	$75.20
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $34.63 / $82.93 / $177.00	Professional	TC	$34.63	$82.93	$177.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $107.05 / $111.00 / $216.00	Professional		$107.05	$111.00	$216.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $32.21 / $32.97 / $77.00	Professional	26	$32.21	$32.97	$77.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $74.84 / $78.03 / $139.00	Professional	TC	$74.84	$78.03	$139.00
United Facility/Professional Professional Modifier Low / Median / High Price $68.93 / $115.13 / $222.15	Professional		$68.93	$115.13	$222.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.72 / $35.15 / $64.50	Professional	26	$19.72	$35.15	$64.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.21 / $79.40 / $145.12	Professional	TC	$49.21	$79.40	$145.12