Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $111.47 / $124.45 / $124.45	Facility	26	$111.47	$124.45	$124.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $342.31 / $402.66 / $611.38	Professional	TC	$342.31	$402.66	$611.38
Capital Blue Cross Facility/Professional Professional Modifier TC Low / Median / High Price $415.10 / $567.09 / $687.21	Professional	TC	$415.10	$567.09	$687.21
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $132.76 / $132.76 / $132.76	Facility	26	$132.76	$132.76	$132.76
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $367.82 / $491.93 / $876.26	Professional	TC	$367.82	$491.93	$876.26
Emblem Health Facility/Professional Professional Modifier TC Low / Median / High Price $457.27 / $666.04 / $869.19	Professional	TC	$457.27	$666.04	$869.19
Martin's Point Facility/Professional Facility Modifier 26 Low / Median / High Price $124.45 / $124.45 / $124.45	Facility	26	$124.45	$124.45	$124.45
Martin's Point Facility/Professional Professional Modifier TC Low / Median / High Price $348.98 / $441.07 / $970.16	Professional	TC	$348.98	$441.07	$970.16
Priority Health Facility/Professional Facility Modifier 26 Low / Median / High Price $132.76 / $132.76 / $132.76	Facility	26	$132.76	$132.76	$132.76
Priority Health Facility/Professional Professional Modifier TC Low / Median / High Price $378.70 / $493.55 / $876.26	Professional	TC	$378.70	$493.55	$876.26
UPMC Health Plan Facility/Professional Facility Modifier 26 Low / Median / High Price $104.33 / $114.09 / $114.09	Facility	26	$104.33	$114.09	$114.09
UPMC Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $397.64 / $406.55 / $447.55	Professional	TC	$397.64	$406.55	$447.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $328.57 / $444.54 / $768.88	Professional	TC	$328.57	$444.54	$768.88