Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $428.61 / $1,396.78 / $3,340.00	Facility		$428.61	$1,396.78	$3,340.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $33.15 / $33.15 / $63.69	Facility	52	$33.15	$33.15	$63.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.45 / $118.50 / $468.04	Professional		$64.45	$118.50	$468.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.11 / $200.34 / $223.05	Professional		$106.11	$200.34	$223.05
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,006.83 / $1,637.01 / $4,606.20	Facility		$1,006.83	$1,637.01	$4,606.20
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $74.14 / $74.14 / $74.14	Professional		$74.14	$74.14	$74.14
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,344.69 / $3,159.00 / $14,886.03	Facility		$2,344.69	$3,159.00	$14,886.03
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $115.08 / $190.55 / $233.13	Professional		$115.08	$190.55	$233.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.45 / $140.59 / $257.97	Professional		$80.45	$140.59	$257.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $155.66 / $206.05 / $210.89	Professional		$155.66	$206.05	$210.89
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $472.66 / $1,488.71 / $2,548.00	Facility		$472.66	$1,488.71	$2,548.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.03 / $159.27 / $219.20	Professional		$118.03	$159.27	$219.20
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $845.79 / $1,610.46 / $2,930.54	Facility		$845.79	$1,610.46	$2,930.54
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $74.14 / $74.14 / $74.14	Professional		$74.14	$74.14	$74.14
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $252.21 / $1,477.38 / $3,682.22	Facility		$252.21	$1,477.38	$3,682.22
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $33.15 / $33.15 / $63.69	Facility	52	$33.15	$33.15	$63.69
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $64.50 / $125.78 / $420.00	Professional		$64.50	$125.78	$420.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,116.47 / $1,153.68 / $5,549.44	Facility		$1,116.47	$1,153.68	$5,549.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $139.10 / $363.50	Professional		$3.00	$139.10	$363.50
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $81.23 / $141.54 / $258.31	Professional		$81.23	$141.54	$258.31
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $72.08 / $82.20 / $137.49	Facility		$72.08	$82.20	$137.49
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $72.08 / $129.22 / $140.82	Professional		$72.08	$129.22	$140.82
United Facility/Professional Facility Modifier Low / Median / High Price $471.00 / $1,305.00 / $3,742.00	Facility		$471.00	$1,305.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $114.78 / $154.29 / $269.94	Professional		$114.78	$154.29	$269.94