Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.43 / $16.43 / $104.33	Facility	26	$16.43	$16.43	$104.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.64 / $46.99 / $67.67	Professional		$42.64	$46.99	$67.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.82 / $14.81 / $17.45	Professional	26	$12.82	$14.81	$17.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.84 / $33.24 / $48.60	Professional	TC	$29.84	$33.24	$48.60
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $35.45 / $41.70 / $93.40	Professional		$35.45	$41.70	$93.40
Capital Blue Cross Facility/Professional Professional Modifier 26 Low / Median / High Price $12.18 / $14.33 / $27.54	Professional	26	$12.18	$14.33	$27.54
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $23.27 / $27.38 / $65.86	Professional	TC	$23.27	$27.38	$65.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.48 / $65.59 / $106.91	Professional		$41.48	$65.59	$106.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.71 / $19.16 / $31.75	Professional	26	$13.71	$19.16	$31.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.77 / $45.80 / $72.89	Professional	TC	$27.77	$45.80	$72.89
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.76 / $62.79 / $116.21	Professional		$44.76	$62.79	$116.21
Emblem Health Facility/Professional Professional Modifier 26 Low / Median / High Price $15.17 / $19.73 / $36.38	Professional	26	$15.17	$19.73	$36.38
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.59 / $43.05 / $79.83	Professional	TC	$29.59	$43.05	$79.83
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $16.43 / $20.60 / $104.33	Facility	26	$16.43	$20.60	$104.33
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $50.71 / $130.09	Professional		$43.65	$50.71	$130.09
Martin's Point Facility/Professional Professional Modifier 26 Low / Median / High Price $13.14 / $15.21 / $23.08	Professional	26	$13.14	$15.21	$23.08
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $29.84 / $33.74 / $66.53	Professional	TC	$29.84	$33.74	$66.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $26.20 / $81.70 / $127.60	Professional		$26.20	$81.70	$127.60
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $41.48 / $65.05 / $107.05	Professional		$41.48	$65.05	$107.05
Priority Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.71 / $19.14 / $32.90	Professional	26	$13.71	$19.14	$32.90
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $27.77 / $44.85 / $75.30	Professional	TC	$27.77	$44.85	$75.30
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $13.97 / $13.97 / $18.00	Facility	26	$13.97	$13.97	$18.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $43.06 / $43.68 / $61.00	Professional		$43.06	$43.68	$61.00
UPMC Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.64 / $13.97 / $18.00	Professional	26	$13.64	$13.97	$18.00
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $29.10 / $29.71 / $43.00	Professional	TC	$29.10	$29.71	$43.00
United Facility/Professional Professional Modifier Low / Median / High Price $44.48 / $58.15 / $95.96	Professional		$44.48	$58.15	$95.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.27 / $17.89 / $28.56	Professional	26	$13.27	$17.89	$28.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.01 / $41.81 / $68.79	Professional	TC	$31.01	$41.81	$68.79