Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.40 / $100.77 / $100.77	Facility	26	$85.40	$100.77	$100.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $53.35 / $63.66	Professional		$36.65	$53.35	$63.66
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.04 / $19.07 / $22.57	Professional	26	$12.04	$19.07	$22.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.62 / $33.95 / $41.10	Professional	TC	$24.62	$33.95	$41.10
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $64.06 / $90.69 / $113.91	Professional		$64.06	$90.69	$113.91
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $24.66 / $34.60 / $43.49	Professional	26	$24.66	$34.60	$43.49
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $39.40 / $56.08 / $70.44	Professional	TC	$39.40	$56.08	$70.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.72 / $54.72 / $54.72	Facility	26	$54.72	$54.72	$54.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.83 / $46.90 / $92.25	Professional		$28.83	$46.90	$92.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $14.39 / $32.54	Professional	26	$10.35	$14.39	$32.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.45 / $26.23 / $61.21	Professional	TC	$18.45	$26.23	$61.21
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $41.29 / $95.12 / $125.33	Professional		$41.29	$95.12	$125.33
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.87 / $33.89 / $44.40	Professional	26	$14.87	$33.89	$44.40
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.43 / $61.52 / $81.73	Professional	TC	$26.43	$61.52	$81.73
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $100.77 / $100.77 / $100.77	Facility	26	$100.77	$100.77	$100.77
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $43.52 / $54.41 / $271.83	Professional		$43.52	$54.41	$271.83
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $16.75 / $20.46 / $100.77	Professional	26	$16.75	$20.46	$100.77
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $26.77 / $33.95 / $171.07	Professional	TC	$26.77	$33.95	$171.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.98 / $56.61 / $110.93	Professional		$23.98	$56.61	$110.93
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $54.72 / $54.72 / $54.72	Facility	26	$54.72	$54.72	$54.72
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $28.83 / $53.36 / $96.37	Professional		$28.83	$53.36	$96.37
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.45 / $19.55 / $34.00	Professional	26	$10.45	$19.55	$34.00
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.45 / $33.81 / $64.86	Professional	TC	$18.45	$33.81	$64.86
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $65.81 / $70.68	Professional		$63.00	$65.81	$70.68
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $22.78 / $24.40 / $25.09	Professional	26	$22.78	$24.40	$25.09
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $40.22 / $41.42 / $45.59	Professional	TC	$40.22	$41.42	$45.59
United Facility/Professional Professional Modifier Low / Median / High Price $41.41 / $69.19 / $108.99	Professional		$41.41	$69.19	$108.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.40 / $26.75 / $41.06	Professional	26	$14.40	$26.75	$41.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.36 / $44.29 / $68.04	Professional	TC	$24.36	$44.29	$68.04