Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.13 / $641.00 / $5,627.00	Facility		$84.13	$641.00	$5,627.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $237.28 / $637.25 / $2,255.00	Facility	50	$237.28	$637.25	$2,255.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.90 / $80.15 / $193.29	Professional		$51.90	$80.15	$193.29
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $122.29 / $188.62 / $523.50	Professional	50	$122.29	$188.62	$523.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.80 / $125.61 / $125.61	Professional		$62.80	$125.61	$125.61
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $188.41 / $188.41 / $225.72	Professional	50	$188.41	$188.41	$225.72
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $84.68 / $148.46 / $168.75	Professional		$84.68	$148.46	$168.75
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 $81.80 / $119.62 / $167.53	Professional		$81.80	$119.62	$167.53
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $122.70 / $179.73 / $251.30	Professional	50	$122.70	$179.73	$251.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.49 / $96.49 / $96.49	Facility		$96.49	$96.49	$96.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.14 / $84.53 / $141.37	Professional		$57.14	$84.53	$141.37
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $97.31 / $130.81 / $168.07	Professional		$97.31	$130.81	$168.07
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $235.66 / $1,192.92 / $1,325.15	Facility		$235.66	$1,192.92	$1,325.15
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $499.56 / $843.32 / $1,984.69	Facility	50	$499.56	$843.32	$1,984.69
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.95 / $102.55 / $128.34	Professional		$66.95	$102.55	$128.34
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $100.43 / $155.28 / $200.53	Professional	50	$100.43	$155.28	$200.53
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $84.68 / $94.84 / $168.75	Professional		$84.68	$94.84	$168.75
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $76.09 / $1,161.76 / $5,958.00	Facility		$76.09	$1,161.76	$5,958.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $637.25 / $1,211.50 / $6,206.73	Facility	50	$637.25	$1,211.50	$6,206.73
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $55.29 / $91.30 / $185.26	Professional		$55.29	$91.30	$185.26
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $122.29 / $188.19 / $510.00	Professional	50	$122.29	$188.19	$510.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $78.80 / $78.80 / $166.00	Professional		$78.80	$78.80	$166.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $96.49 / $96.49 / $96.49	Facility		$96.49	$96.49	$96.49
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $57.33 / $86.10 / $145.47	Professional		$57.33	$86.10	$145.47
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $55.18 / $55.72 / $79.75	Facility		$55.18	$55.72	$79.75
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $55.18 / $71.04 / $85.07	Professional		$55.18	$71.04	$85.07
United Facility/Professional Facility Modifier Low / Median / High Price $364.00 / $711.76 / $3,742.00	Facility		$364.00	$711.76	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $68.44 / $94.03 / $154.71	Professional		$68.44	$94.03	$154.71