Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.36 / $624.95 / $3,340.00	Facility		$69.36	$624.95	$3,340.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.54 / $64.34 / $215.92	Professional		$38.54	$64.34	$215.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.19 / $65.19 / $91.22	Professional		$65.19	$65.19	$91.22
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $64.84 / $72.98 / $130.33	Professional		$64.84	$72.98	$130.33
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 $59.40 / $89.20 / $133.38	Professional		$59.40	$89.20	$133.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.38 / $70.38 / $70.38	Facility		$70.38	$70.38	$70.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.46 / $64.15 / $114.60	Professional		$42.46	$64.15	$114.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $70.09 / $93.18 / $121.07	Professional		$70.09	$93.18	$121.07
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $350.05 / $702.23 / $1,293.13	Facility		$350.05	$702.23	$1,293.13
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.75 / $76.70 / $81.31	Professional		$67.75	$76.70	$81.31
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $64.84 / $130.33 / $131.54	Professional		$64.84	$130.33	$131.54
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $58.15 / $832.01 / $4,761.00	Facility		$58.15	$832.01	$4,761.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $40.88 / $72.84 / $147.07	Professional		$40.88	$72.84	$147.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.53 / $78.80 / $122.54	Professional		$54.53	$78.80	$122.54
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $70.38 / $70.38 / $70.38	Facility		$70.38	$70.38	$70.38
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $42.65 / $64.44 / $118.19	Professional		$42.65	$64.44	$118.19
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $41.45 / $47.17 / $60.85	Facility		$41.45	$47.17	$60.85
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $41.45 / $58.09 / $63.26	Professional		$41.45	$58.09	$63.26
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 $53.82 / $75.98 / $125.02	Professional		$53.82	$75.98	$125.02