Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $933.25 / $4,265.80	Facility		$66.07	$933.25	$4,265.80
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $74.13 / $1,318.26 / $2,570.40	Facility	50	$74.13	$1,318.26	$2,570.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $81.28 / $263.03	Professional		$38.90	$81.28	$263.03
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $125.89 / $338.84	Professional	50	$74.13	$125.89	$338.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $57.54 / $89.13	Professional		$46.77	$57.54	$89.13
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $83.18 / $131.83	Professional	50	$72.44	$83.18	$131.83
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,230.27 / $57,543.99	Facility		$1,174.90	$1,230.27	$57,543.99
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $83.18 / $109.65	Professional		$57.54	$83.18	$109.65
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $87.10 / $125.89 / $162.18	Professional	50	$87.10	$125.89	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $66.07 / $66.07	Facility		$66.07	$66.07	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $60.26 / $102.33	Professional		$39.81	$60.26	$102.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $97.72 / $123.03	Professional		$72.44	$97.72	$123.03
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $66.07 / $102.33	Professional		$41.69	$66.07	$102.33
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $630.96 / $1,318.26	Facility		$173.78	$630.96	$1,318.26
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $575.44 / $1,148.15 / $2,041.74	Facility	50	$575.44	$1,148.15	$2,041.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $70.79 / $85.11	Professional		$60.26	$70.79	$85.11
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $97.72 / $104.71 / $117.49	Professional	50	$97.72	$104.71	$117.49
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $61.66 / $131.83	Professional		$58.88	$61.66	$131.83
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $891.25 / $4,168.69	Facility		$58.88	$891.25	$4,168.69
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $74.13 / $1,122.02 / $2,570.40	Facility	50	$74.13	$1,122.02	$2,570.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $70.79 / $194.98	Professional		$38.90	$70.79	$194.98
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $144.54 / $363.08	Professional	50	$74.13	$144.54	$363.08
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $117.49	Facility		$100.00	$100.00	$117.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $125.89	Professional		$89.13	$89.13	$125.89
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $15.85 / $47.86 / $117.49	Facility		$15.85	$47.86	$117.49
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $54.95 / $141.25	Professional		$23.44	$54.95	$141.25
United Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $831.76 / $3,890.45	Facility		$223.87	$831.76	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $56.23 / $91.20	Professional		$36.31	$56.23	$91.20