Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.84 / $60.83 / $126.28	Professional		$52.84	$60.83	$126.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.92 / $35.53 / $47.38	Professional	26	$30.92	$35.53	$47.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.06 / $24.51 / $31.67	Professional	TC	$21.06	$24.51	$31.67
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $57.83 / $77.84 / $237.94	Professional		$57.83	$77.84	$237.94
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $62.43 / $64.79 / $64.79	Professional		$62.43	$64.79	$64.79
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $36.36 / $37.74 / $84.53	Professional	26	$36.36	$37.74	$84.53
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $26.07 / $27.05 / $46.59	Professional	TC	$26.07	$27.05	$46.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.59 / $41.59 / $41.59	Facility	26	$41.59	$41.59	$41.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.38 / $65.25 / $121.09	Professional		$49.38	$65.25	$121.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.17 / $40.31 / $79.23	Professional	26	$29.17	$40.31	$79.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.50 / $26.80 / $49.23	Professional	TC	$18.50	$26.80	$49.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $86.46 / $129.40	Professional		$73.81	$86.46	$129.40
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.48 / $50.07 / $74.93	Professional	26	$41.48	$50.07	$74.93
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $32.33 / $36.40 / $54.47	Professional	TC	$32.33	$36.40	$54.47
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.18 / $77.84 / $186.88	Professional		$58.18	$77.84	$186.88
Highmark BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.11 / $60.24 / $74.04	Professional	26	$44.11	$60.24	$74.04
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $64.48 / $65.41 / $127.45	Professional		$64.48	$65.41	$127.45
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $55.09 / $65.52 / $136.35	Professional		$55.09	$65.52	$136.35
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $31.42 / $37.39 / $77.02	Professional	26	$31.42	$37.39	$77.02
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $21.76 / $25.80 / $38.22	Professional	TC	$21.76	$25.80	$38.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $88.50 / $88.50 / $88.50	Professional		$88.50	$88.50	$88.50
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $41.59 / $41.59 / $41.59	Facility	26	$41.59	$41.59	$41.59
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $49.11 / $67.68 / $121.09	Professional		$49.11	$67.68	$121.09
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $28.50 / $41.06 / $79.62	Professional	26	$28.50	$41.06	$79.62
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.50 / $27.05 / $50.31	Professional	TC	$18.50	$27.05	$50.31
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $35.70 / $35.70 / $37.00	Facility	26	$35.70	$35.70	$37.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $60.99 / $65.05	Professional		$55.00	$60.99	$65.05
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $35.02 / $35.70 / $37.21	Professional	26	$35.02	$35.70	$37.21
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $25.28 / $27.84	Professional	TC	$18.00	$25.28	$27.84
United Facility/Professional Professional Modifier Low / Median / High Price $49.15 / $62.12 / $106.38	Professional		$49.15	$62.12	$106.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.82 / $37.10 / $64.68	Professional	26	$27.82	$37.10	$64.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.53 / $24.54 / $41.73	Professional	TC	$16.53	$24.54	$41.73