Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,023.29 / $2,089.30	Facility		$416.87	$1,023.29	$2,089.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $1,023.29	Professional		$416.87	$416.87	$1,023.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Professional		$416.87	$416.87	$416.87
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $416.87 / $416.87	Facility		$117.49	$416.87	$416.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Professional		$416.87	$416.87	$416.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $630.96 / $1,412.54	Facility		$281.84	$630.96	$1,412.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Professional		$1,995.26	$1,995.26	$1,995.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $562.34 / $912.01	Professional		$436.52	$562.34	$912.01
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Facility		$416.87	$416.87	$416.87
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $316.23 / $707.95	Professional		$186.21	$316.23	$707.95
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,023.29 / $1,412.54	Facility		$398.11	$1,023.29	$1,412.54
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $138.04	Professional		$123.03	$123.03	$138.04
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $1,288.25 / $2,398.83	Facility		$416.87	$1,288.25	$2,398.83
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $489.78	Professional		$489.78	$489.78	$489.78
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $977.24 / $1,819.70	Facility		$416.87	$977.24	$1,819.70
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $1,288.25	Professional		$416.87	$416.87	$1,288.25
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,089.30 / $2,570.40	Facility		$1,000.00	$2,089.30	$2,570.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $741.31	Professional		$416.87	$416.87	$741.31
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $416.87 / $588.84	Facility		$85.11	$416.87	$588.84
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $446.68 / $588.84	Professional		$85.11	$446.68	$588.84
United Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $501.19	Facility		$416.87	$416.87	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $251.19 / $616.60	Professional		$173.78	$251.19	$616.60