Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.71 / $47.71 / $77.53	Facility	26	$47.71	$47.71	$77.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.89 / $341.41 / $492.50	Professional		$292.89	$341.41	$492.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $146.44 / $170.71 / $203.35	Professional	52	$146.44	$170.71	$203.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.77 / $297.80 / $428.54	Professional	TC	$252.77	$297.80	$428.54
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $357.18 / $485.95 / $612.69	Professional		$357.18	$485.95	$612.69
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $312.75 / $424.62 / $533.78	Professional	TC	$312.75	$424.62	$533.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.88 / $50.88 / $50.88	Facility	26	$50.88	$50.88	$50.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $265.89 / $398.72 / $689.76	Professional		$265.89	$398.72	$689.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $266.42 / $363.60 / $685.99	Professional	TC	$266.42	$363.60	$685.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $388.49 / $566.66 / $745.92	Professional		$388.49	$566.66	$745.92
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $344.58 / $501.88 / $654.86	Professional	TC	$344.58	$501.88	$654.86
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $47.71 / $77.53 / $141.69	Facility	26	$47.71	$77.53	$141.69
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $292.89 / $372.15 / $814.26	Professional		$292.89	$372.15	$814.26
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $149.59 / $175.71 / $254.41	Professional	52	$149.59	$175.71	$254.41
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $252.77 / $323.49 / $702.70	Professional	TC	$252.77	$323.49	$702.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $46.74 / $366.96 / $659.97	Professional		$46.74	$366.96	$659.97
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $50.88 / $50.88 / $50.88	Facility	26	$50.88	$50.88	$50.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $117.60 / $398.72 / $792.73	Professional		$117.60	$398.72	$792.73
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $277.39 / $365.69 / $685.99	Professional	TC	$277.39	$365.69	$685.99
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $39.63 / $43.65 / $43.65	Facility	26	$39.63	$43.65	$43.65
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $339.22 / $345.87 / $378.17	Professional		$339.22	$345.87	$378.17
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $295.66 / $302.22 / $332.70	Professional	TC	$295.66	$302.22	$332.70
United Facility/Professional Professional Modifier Low / Median / High Price $292.50 / $369.75 / $647.22	Professional		$292.50	$369.75	$647.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.53 / $342.40 / $575.98	Professional	TC	$244.53	$342.40	$575.98