Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.76 / $131.87 / $131.87	Facility	26	$111.76	$131.87	$131.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.68 / $90.13 / $235.96	Professional		$44.68	$90.13	$235.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.24 / $25.56 / $63.35	Professional	26	$14.24	$25.56	$63.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.45 / $64.47 / $184.26	Professional	TC	$30.45	$64.47	$184.26
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $126.34 / $131.11 / $191.92	Professional		$126.34	$131.11	$191.92
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $33.22 / $41.70 / $55.49	Professional	26	$33.22	$41.70	$55.49
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $84.17 / $96.65 / $138.77	Professional	TC	$84.17	$96.65	$138.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	26	$50.00	$50.00	$50.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.14 / $65.18 / $141.15	Professional		$35.14	$65.18	$141.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.31 / $17.59 / $41.44	Professional	26	$12.31	$17.59	$41.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.80 / $45.19 / $102.52	Professional	TC	$22.80	$45.19	$102.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $82.70 / $191.35 / $252.76	Professional		$82.70	$191.35	$252.76
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $45.90 / $60.16	Professional	26	$20.30	$45.90	$60.16
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $62.40 / $145.44 / $192.59	Professional	TC	$62.40	$145.44	$192.59
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $34.89 / $34.89 / $34.89	Professional	26	$34.89	$34.89	$34.89
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $131.87 / $131.87 / $131.87	Facility	26	$131.87	$131.87	$131.87
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $73.84 / $95.12 / $481.81	Professional		$73.84	$95.12	$481.81
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $22.56 / $25.66 / $131.87	Professional	26	$22.56	$25.66	$131.87
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $51.16 / $69.90 / $349.89	Professional	TC	$51.16	$69.90	$349.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.79 / $119.55 / $216.27	Professional		$32.79	$119.55	$216.27
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	26	$50.00	$50.00	$50.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $35.14 / $66.63 / $149.38	Professional		$35.14	$66.63	$149.38
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.36 / $23.27 / $42.31	Professional	26	$12.36	$23.27	$42.31
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.80 / $48.64 / $107.10	Professional	TC	$22.80	$48.64	$107.10
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $76.79 / $116.66 / $126.30	Professional		$76.79	$116.66	$126.30
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $27.08 / $31.93 / $33.03	Professional	26	$27.08	$31.93	$33.03
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $49.71 / $84.72 / $93.27	Professional	TC	$49.71	$84.72	$93.27
United Facility/Professional Professional Modifier Low / Median / High Price $60.96 / $110.83 / $174.29	Professional		$60.96	$110.83	$174.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.55 / $33.39 / $50.09	Professional	26	$17.55	$33.39	$50.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.59 / $77.44 / $109.42	Professional	TC	$42.59	$77.44	$109.42