Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.13 / $27.89 / $27.89	Facility	26	$25.13	$27.89	$27.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.34 / $156.00 / $197.49	Professional		$124.34	$156.00	$197.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $101.86 / $129.07 / $159.74	Professional	TC	$101.86	$129.07	$159.74
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $149.50 / $175.88 / $259.80	Professional		$149.50	$175.88	$259.80
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $125.88 / $148.09 / $215.90	Professional	TC	$125.88	$148.09	$215.90
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.71 / $30.71 / $30.71	Facility	26	$30.71	$30.71	$30.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.55 / $169.09 / $300.95	Professional		$92.55	$169.09	$300.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.25 / $144.10 / $266.61	Professional	TC	$75.25	$144.10	$266.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $183.92 / $268.25 / $353.41	Professional		$183.92	$268.25	$353.41
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $157.68 / $229.47 / $298.48	Professional	TC	$157.68	$229.47	$298.48
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $27.89 / $27.89 / $27.89	Facility	26	$27.89	$27.89	$27.89
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $133.72 / $164.77 / $416.29	Professional		$133.72	$164.77	$416.29
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $106.97 / $137.07 / $347.63	Professional	TC	$106.97	$137.07	$347.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.09 / $156.03 / $305.41	Professional		$28.09	$156.03	$305.41
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $30.71 / $30.71 / $30.88	Facility	26	$30.71	$30.71	$30.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $89.33 / $168.01 / $300.95	Professional		$89.33	$168.01	$300.95
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.81 / $146.01 / $283.56	Professional	TC	$75.81	$146.01	$283.56
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $26.18 / $26.18 / $44.48	Facility	26	$26.18	$26.18	$44.48
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $155.21 / $157.99 / $172.32	Professional		$155.21	$157.99	$172.32
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $129.08 / $131.81 / $145.12	Professional	TC	$129.08	$131.81	$145.12
United Facility/Professional Professional Modifier Low / Median / High Price $94.36 / $153.69 / $258.63	Professional		$94.36	$153.69	$258.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.59 / $120.96 / $206.96	Professional	TC	$78.59	$120.96	$206.96