Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.38 / $394.02 / $1,499.00	Facility		$130.38	$394.02	$1,499.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.68 / $110.55 / $382.00	Professional		$52.68	$110.55	$382.00
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $408.93 / $926.96 / $1,659.42	Facility		$408.93	$926.96	$1,659.42
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,083.51 / $1,395.00 / $12,759.45	Facility		$1,083.51	$1,395.00	$12,759.45
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $109.77 / $113.92 / $178.72	Professional		$109.77	$113.92	$178.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.22 / $111.10 / $210.00	Professional		$55.22	$111.10	$210.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $133.29 / $171.37 / $177.33	Professional		$133.29	$171.37	$177.33
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $214.75 / $445.05 / $621.09	Facility		$214.75	$445.05	$621.09
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.51 / $110.97 / $111.96	Professional		$109.51	$110.97	$111.96
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $212.46 / $707.58 / $1,659.42	Facility		$212.46	$707.58	$1,659.42
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $107.20 / $540.00 / $2,900.00	Facility		$107.20	$540.00	$2,900.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $54.14 / $115.09 / $377.70	Professional		$54.14	$115.09	$377.70
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $984.02 / $1,035.20 / $1,264.95	Facility		$984.02	$1,035.20	$1,264.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.72 / $173.30 / $173.30	Professional		$56.72	$173.30	$173.30
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $95.46 / $95.46 / $95.46	Facility		$95.46	$95.46	$95.46
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $56.32 / $111.56 / $220.13	Professional		$56.32	$111.56	$220.13
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $54.10 / $98.54 / $148.61	Facility		$54.10	$98.54	$148.61
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $54.10 / $106.69 / $117.02	Professional		$54.10	$106.69	$117.02
United Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $674.00 / $4,300.00	Facility		$144.00	$674.00	$4,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $98.22 / $128.41 / $215.46	Professional		$98.22	$128.41	$215.46