Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $831.76 / $4,265.80	Facility		$81.28	$831.76	$4,265.80
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $407.38 / $1,174.90 / $2,398.83	Facility	50	$407.38	$1,174.90	$2,398.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $72.44 / $204.17	Professional		$37.15	$72.44	$204.17
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $75.86 / $138.04 / $380.19	Professional	50	$75.86	$138.04	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $51.29 / $67.61	Professional		$37.15	$51.29	$67.61
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $52.48 / $75.86 / $128.82	Professional	50	$52.48	$75.86	$128.82
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 $53.70 / $77.62 / $104.71	Professional		$53.70	$77.62	$104.71
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $81.28 / $117.49 / $158.49	Professional	50	$81.28	$117.49	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $58.88 / $97.72	Professional		$38.02	$58.88	$97.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $93.33 / $117.49	Professional		$67.61	$93.33	$117.49
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $64.57 / $104.71	Professional		$42.66	$64.57	$104.71
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $676.08 / $1,348.96	Facility		$239.88	$676.08	$1,348.96
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $794.33 / $1,318.26 / $1,995.26	Facility	50	$794.33	$1,318.26	$1,995.26
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $66.07 / $83.18	Professional		$47.86	$66.07	$83.18
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $93.33 / $97.72 / $112.20	Professional	50	$93.33	$97.72	$112.20
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $812.83 / $4,073.80	Facility		$70.79	$812.83	$4,073.80
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $436.52 / $1,174.90 / $2,454.71	Facility	50	$436.52	$1,174.90	$2,454.71
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $66.07 / $151.36	Professional		$37.15	$66.07	$151.36
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $144.54 / $380.19	Professional	50	$77.62	$144.54	$380.19
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $87.10 / $112.20	Facility		$87.10	$87.10	$112.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $75.86 / $120.23	Professional		$72.44	$75.86	$120.23
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $11.75 / $40.74 / $57.54	Facility		$11.75	$40.74	$57.54
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $11.75 / $36.31 / $70.79	Professional		$11.75	$36.31	$70.79
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 / $53.70 / $89.13	Professional		$36.31	$53.70	$89.13