Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.15 / $48.98 / $48.98	Facility	26	$44.15	$48.98	$48.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.77 / $98.83 / $114.45	Professional		$84.77	$98.83	$114.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.27 / $53.23 / $64.93	Professional	TC	$45.27	$53.23	$64.93
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $78.72 / $90.22 / $173.05	Professional		$78.72	$90.22	$173.05
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $37.01 / $43.54 / $84.75	Professional	TC	$37.01	$43.54	$84.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.06 / $52.06 / $52.06	Facility	26	$52.06	$52.06	$52.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.81 / $115.35 / $202.19	Professional		$78.81	$115.35	$202.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.30 / $55.54 / $107.45	Professional	TC	$31.30	$55.54	$107.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $90.40 / $132.49 / $177.88	Professional		$90.40	$132.49	$177.88
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.53 / $67.64 / $87.62	Professional	TC	$46.53	$67.64	$87.62
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.07 / $110.74 / $115.37	Professional		$109.07	$110.74	$115.37
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $48.98 / $48.98	Facility	26	$48.98	$48.98	$48.98
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $88.36 / $98.85 / $151.72	Professional		$88.36	$98.85	$151.72
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $53.44 / $83.50	Professional	TC	$46.77	$53.44	$83.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.61 / $79.90 / $159.87	Professional		$43.61	$79.90	$159.87
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $52.06 / $52.06 / $53.00	Facility	26	$52.06	$52.06	$53.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $78.81 / $116.81 / $215.92	Professional		$78.81	$116.81	$215.92
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $31.30 / $58.19 / $110.34	Professional	TC	$31.30	$58.19	$110.34
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $44.83 / $44.83 / $51.16	Facility	26	$44.83	$44.83	$51.16
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $92.07 / $93.50 / $100.05	Professional		$92.07	$93.50	$100.05
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $47.70 / $48.67 / $53.59	Professional	TC	$47.70	$48.67	$53.59
United Facility/Professional Professional Modifier Low / Median / High Price $72.36 / $103.96 / $189.89	Professional		$72.36	$103.96	$189.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $34.65 / $52.47 / $95.62	Professional	TC	$34.65	$52.47	$95.62