Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $213.80 / $323.59	Facility		$107.15	$213.80	$323.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $63.10 / $87.10	Professional		$46.77	$63.10	$87.10
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,511.38 / $77,624.71	Facility		$5,011.87	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Professional		$61.66	$61.66	$61.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $120.23 / $269.15	Facility		$52.48	$120.23	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $380.19 / $380.19	Professional		$380.19	$380.19	$380.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $107.15 / $169.82	Professional		$83.18	$107.15	$169.82
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $131.83 / $199.53	Professional		$85.11	$131.83	$199.53
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $199.53 / $323.59	Facility		$107.15	$199.53	$323.59
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $64.57 / $199.53	Professional		$46.77	$64.57	$199.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $131.83	Professional		$87.10	$117.49	$131.83
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $52.48 / $407.38	Facility		$30.90	$52.48	$407.38
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $52.48 / $407.38	Professional		$13.49	$52.48	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $47.86 / $97.72	Professional		$33.11	$47.86	$97.72