Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.56 / $280.17 / $2,747.00	Facility		$122.56	$280.17	$2,747.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.67 / $117.28 / $285.54	Professional		$58.67	$117.28	$285.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $241.97 / $241.97 / $241.97	Professional	50	$241.97	$241.97	$241.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.47 / $47.27 / $70.58	Professional	52	$28.47	$47.27	$70.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.78 / $115.39 / $190.39	Professional		$99.78	$115.39	$190.39
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $90.02 / $108.12 / $190.03	Professional		$90.02	$108.12	$190.03
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 $109.82 / $179.10 / $197.20	Professional		$109.82	$179.10	$197.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.29 / $103.60 / $177.35	Professional		$62.29	$103.60	$177.35
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $9.60 / $133.25 / $176.43	Professional		$9.60	$133.25	$176.43
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.05 / $514.29 / $1,013.23	Facility		$275.05	$514.29	$1,013.23
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.93 / $109.25 / $134.85	Professional		$65.93	$109.25	$134.85
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $54.63 / $54.63 / $54.63	Professional	52	$54.63	$54.63	$54.63
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $90.02 / $109.08 / $190.03	Professional		$90.02	$109.08	$190.03
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $105.12 / $641.00 / $5,868.00	Facility		$105.12	$641.00	$5,868.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $60.42 / $118.91 / $262.45	Professional		$60.42	$118.91	$262.45
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $28.49 / $48.67 / $97.68	Professional	52	$28.49	$48.67	$97.68
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.84 / $87.70 / $156.09	Professional		$64.84	$87.70	$156.09
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $114.34 / $114.34 / $114.34	Facility		$114.34	$114.34	$114.34
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $63.69 / $104.65 / $195.67	Professional		$63.69	$104.65	$195.67
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $61.39 / $64.76 / $109.34	Facility		$61.39	$64.76	$109.34
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $63.57 / $96.78 / $118.28	Professional		$63.57	$96.78	$118.28
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 $92.52 / $122.61 / $193.85	Professional		$92.52	$122.61	$193.85