Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $726.87 / $3,245.00 / $7,104.00	Facility		$726.87	$3,245.00	$7,104.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.34 / $29.34 / $95.64	Facility	53	$29.34	$29.34	$95.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.71 / $444.26 / $1,410.71	Professional		$146.71	$444.26	$1,410.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $228.42 / $235.49 / $741.24	Professional		$228.42	$235.49	$741.24
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,716.87 / $3,574.87 / $10,452.24	Facility		$2,716.87	$3,574.87	$10,452.24
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $168.65 / $168.65 / $168.65	Professional		$168.65	$168.65	$168.65
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $3,736.00 / $4,444.00 / $15,949.31	Facility		$3,736.00	$4,444.00	$15,949.31
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $415.45 / $817.92 / $1,276.72	Professional		$415.45	$817.92	$1,276.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.69 / $467.97 / $1,110.58	Professional		$182.69	$467.97	$1,110.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $733.90 / $756.05 / $1,674.13	Professional		$733.90	$756.05	$1,674.13
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,218.60 / $3,646.29 / $7,549.69	Facility		$1,218.60	$3,646.29	$7,549.69
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.03 / $182.48 / $388.94	Professional		$165.03	$182.48	$388.94
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,716.87 / $3,574.87 / $8,450.76	Facility		$2,716.87	$3,574.87	$8,450.76
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $168.65 / $168.65 / $168.65	Professional		$168.65	$168.65	$168.65
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $644.16 / $3,402.13 / $7,028.00	Facility		$644.16	$3,402.13	$7,028.00
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $29.34 / $29.34 / $95.64	Facility	53	$29.34	$29.34	$95.64
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $155.78 / $442.40 / $1,410.71	Professional		$155.78	$442.40	$1,410.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $162.41 / $601.01 / $905.80	Professional		$162.41	$601.01	$905.80
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $182.73 / $488.77 / $1,118.90	Professional		$182.73	$488.77	$1,118.90
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $159.55 / $203.91 / $705.10	Facility		$159.55	$203.91	$705.10
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $159.55 / $480.32 / $526.46	Professional		$159.55	$480.32	$526.46
United Facility/Professional Facility Modifier Low / Median / High Price $912.00 / $2,391.00 / $4,789.00	Facility		$912.00	$2,391.00	$4,789.00
United Facility/Professional Professional Modifier Low / Median / High Price $534.70 / $766.40 / $1,286.88	Professional		$534.70	$766.40	$1,286.88