Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.39 / $483.62 / $3,340.00	Facility		$60.39	$483.62	$3,340.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $73.29 / $637.25 / $1,529.58	Facility	50	$73.29	$637.25	$1,529.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.21 / $68.63 / $242.00	Professional		$37.21	$68.63	$242.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $74.91 / $126.96 / $376.50	Professional	50	$74.91	$126.96	$376.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.97 / $67.65 / $97.85	Professional		$48.97	$67.65	$97.85
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $83.16 / $132.43 / $132.43	Professional	50	$83.16	$132.43	$132.43
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $58.31 / $63.79 / $107.39	Professional		$58.31	$63.79	$107.39
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $845.00 / $1,359.00 / $8,459.92	Facility		$845.00	$1,359.00	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $57.49 / $84.46 / $124.86	Professional		$57.49	$84.46	$124.86
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $86.24 / $127.65 / $187.28	Professional	50	$86.24	$127.65	$187.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.77 / $66.77 / $66.77	Facility		$66.77	$66.77	$66.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.38 / $59.97 / $103.61	Professional		$40.38	$59.97	$103.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $73.23 / $91.74 / $160.00	Professional		$73.23	$91.74	$160.00
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.87 / $554.41 / $1,272.23	Facility		$257.87	$554.41	$1,272.23
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $579.05 / $1,310.39 / $1,987.76	Facility	50	$579.05	$1,310.39	$1,987.76
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.68 / $72.67 / $84.93	Professional		$62.68	$72.67	$84.93
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $96.22 / $109.00 / $135.07	Professional	50	$96.22	$109.00	$135.07
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $58.31 / $65.31 / $127.01	Professional		$58.31	$65.31	$127.01
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $55.36 / $900.89 / $4,123.00	Facility		$55.36	$900.89	$4,123.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $43.46 / $1,086.32 / $2,561.10	Facility	50	$43.46	$1,086.32	$2,561.10
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $37.25 / $67.18 / $176.44	Professional		$37.25	$67.18	$176.44
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $81.36 / $127.39 / $340.50	Professional	50	$81.36	$127.39	$340.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $48.46 / $87.76 / $116.30	Professional		$48.46	$87.76	$116.30
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $66.77 / $66.77 / $66.77	Facility		$66.77	$66.77	$66.77
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $40.40 / $61.35 / $104.83	Professional		$40.40	$61.35	$104.83
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $38.29 / $48.00 / $65.98	Facility		$38.29	$48.00	$65.98
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $38.29 / $54.95 / $59.78	Professional		$38.29	$54.95	$59.78
United Facility/Professional Facility Modifier Low / Median / High Price $162.00 / $650.00 / $3,742.00	Facility		$162.00	$650.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $51.42 / $65.44 / $103.71	Professional		$51.42	$65.44	$103.71