Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.43 / $116.26 / $150.35	Professional		$92.43	$116.26	$150.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.16 / $14.82 / $23.04	Professional	26	$13.16	$14.82	$23.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.92 / $102.08 / $124.24	Professional	TC	$78.92	$102.08	$124.24
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $126.59 / $131.36 / $187.53	Professional		$126.59	$131.36	$187.53
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $14.71 / $15.27 / $27.46	Professional	26	$14.71	$15.27	$27.46
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $111.88 / $116.10 / $160.97	Professional	TC	$111.88	$116.10	$160.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.85 / $16.85 / $16.85	Facility	26	$16.85	$16.85	$16.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.02 / $123.95 / $222.28	Professional		$86.02	$123.95	$222.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.85 / $16.70 / $32.60	Professional	26	$12.85	$16.70	$32.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.08 / $109.23 / $198.41	Professional	TC	$72.08	$109.23	$198.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $155.40 / $176.65 / $264.37	Professional		$155.40	$176.65	$264.37
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $16.75 / $20.17 / $30.18	Professional	26	$16.75	$20.17	$30.18
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.63 / $156.47 / $234.16	Professional	TC	$138.63	$156.47	$234.16
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.15 / $156.29 / $165.33	Professional		$153.15	$156.29	$165.33
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $94.49 / $119.02 / $170.06	Professional		$94.49	$119.02	$170.06
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $13.47 / $15.20 / $33.72	Professional	26	$13.47	$15.20	$33.72
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $78.92 / $102.72 / $154.10	Professional	TC	$78.92	$102.72	$154.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.06 / $33.50 / $105.05	Professional		$11.06	$33.50	$105.05
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $16.85 / $16.85 / $16.85	Facility	26	$16.85	$16.85	$16.85
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $87.37 / $126.29 / $222.28	Professional		$87.37	$126.29	$222.28
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.58 / $16.79 / $32.71	Professional	26	$12.58	$16.79	$32.71
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.84 / $111.19 / $207.09	Professional	TC	$72.84	$111.19	$207.09
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $14.56 / $14.56 / $23.00	Facility	26	$14.56	$14.56	$23.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $96.50 / $120.46 / $131.74	Professional		$96.50	$120.46	$131.74
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.24 / $14.56 / $23.00	Professional	26	$14.24	$14.56	$23.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $73.50 / $105.90 / $116.58	Professional	TC	$73.50	$105.90	$116.58
United Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $107.20 / $211.07	Professional		$75.02	$107.20	$211.07
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.18 / $15.21 / $27.36	Professional	26	$11.18	$15.21	$27.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.83 / $91.99 / $181.62	Professional	TC	$60.83	$91.99	$181.62