Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $53.64 / $59.90 / $59.90	Facility	26	$53.64	$59.90	$59.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $298.66 / $383.57 / $712.65	Professional		$298.66	$383.57	$712.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $249.84 / $329.94 / $521.29	Professional	TC	$249.84	$329.94	$521.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $357.39 / $357.39 / $357.39	Professional		$357.39	$357.39	$357.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $353.12 / $415.43 / $675.88	Professional		$353.12	$415.43	$675.88
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $304.19 / $357.87 / $569.58	Professional	TC	$304.19	$357.87	$569.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.88 / $63.88 / $63.88	Facility	26	$63.88	$63.88	$63.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.13 / $424.46 / $769.51	Professional		$250.13	$424.46	$769.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $191.74 / $355.71 / $694.87	Professional	TC	$191.74	$355.71	$694.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $434.44 / $633.91 / $835.97	Professional		$434.44	$633.91	$835.97
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $379.86 / $553.29 / $722.13	Professional	TC	$379.86	$553.29	$722.13
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $59.90 / $59.90 / $59.90	Facility	26	$59.90	$59.90	$59.90
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $316.31 / $427.98 / $863.16	Professional		$316.31	$427.98	$863.16
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $264.98 / $370.68 / $682.22	Professional	TC	$264.98	$370.68	$682.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.06 / $407.30 / $722.94	Professional		$66.06	$407.30	$722.94
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $60.20 / $63.88 / $63.88	Facility	26	$60.20	$63.88	$63.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $269.88 / $456.07 / $843.90	Professional		$269.88	$456.07	$843.90
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $201.04 / $374.14 / $711.21	Professional	TC	$201.04	$374.14	$711.21
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $54.90 / $54.90 / $60.00	Facility	26	$54.90	$54.90	$60.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $387.78 / $395.38 / $431.99	Professional		$387.78	$395.38	$431.99
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $333.05 / $340.48 / $374.81	Professional	TC	$333.05	$340.48	$374.81
United Facility/Professional Professional Modifier Low / Median / High Price $217.50 / $400.98 / $721.86	Professional		$217.50	$400.98	$721.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.50 / $341.61 / $620.66	Professional	TC	$169.50	$341.61	$620.66