Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $389.05 / $630.96	Facility		$173.78	$389.05	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $162.18	Professional		$85.11	$114.82	$162.18
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 $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $229.09 / $489.78	Facility		$138.04	$229.09	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $691.83 / $691.83	Professional		$691.83	$691.83	$691.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $190.55 / $309.03	Professional		$151.36	$190.55	$309.03
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Facility		$141.25	$141.25	$141.25
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $162.18 / $269.15	Professional		$107.15	$162.18	$269.15
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $363.08 / $602.56	Facility		$165.96	$363.08	$602.56
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $416.87	Professional		$85.11	$114.82	$416.87
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $107.15 / $190.55	Facility		$41.69	$107.15	$190.55
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $107.15 / $190.55	Professional		$41.69	$107.15	$190.55
United Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $169.82	Facility		$141.25	$141.25	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $85.11 / $190.55	Professional		$60.26	$85.11	$190.55