Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.47 / $420.48 / $3,485.28	Facility		$57.47	$420.48	$3,485.28
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $408.23 / $431.76 / $1,608.78	Facility	50	$408.23	$431.76	$1,608.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.33 / $60.70 / $129.35	Professional		$36.33	$60.70	$129.35
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.51 / $119.67 / $376.50	Professional	50	$77.51	$119.67	$376.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $48.52 / $72.98 / $102.16	Professional		$48.52	$72.98	$102.16
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $91.61 / $97.09 / $104.01	Professional	50	$91.61	$97.09	$104.01
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $56.28 / $63.03 / $127.99	Professional		$56.28	$63.03	$127.99
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 $54.14 / $79.16 / $118.78	Professional		$54.14	$79.16	$118.78
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $81.22 / $118.83 / $178.18	Professional	50	$81.22	$118.83	$178.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.56 / $62.56 / $62.56	Facility		$62.56	$62.56	$62.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $58.62 / $96.20	Professional		$38.61	$58.62	$96.20
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $69.13 / $86.72 / $110.45	Professional		$69.13	$86.72	$110.45
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $206.01 / $610.87 / $1,310.39	Facility		$206.01	$610.87	$1,310.39
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $796.71 / $1,292.30 / $2,792.20	Facility	50	$796.71	$1,292.30	$2,792.20
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.64 / $69.93 / $87.18	Professional		$53.64	$69.93	$87.18
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $90.80 / $101.97 / $124.92	Professional	50	$90.80	$101.97	$124.92
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $55.88 / $59.72 / $119.93	Professional		$55.88	$59.72	$119.93
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $52.21 / $657.00 / $3,964.00	Facility		$52.21	$657.00	$3,964.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $431.76 / $1,161.76 / $1,608.78	Facility	50	$431.76	$1,161.76	$1,608.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $36.33 / $61.59 / $119.07	Professional		$36.33	$61.59	$119.07
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $72.39 / $119.07 / $376.50	Professional	50	$72.39	$119.07	$376.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $48.41 / $72.00 / $112.80	Professional		$48.41	$72.00	$112.80
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $62.56 / $62.56 / $62.56	Facility		$62.56	$62.56	$62.56
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $58.68 / $99.38	Professional		$38.61	$58.68	$99.38
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $36.22 / $41.20 / $57.95	Facility		$36.22	$41.20	$57.95
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $36.22 / $52.32 / $57.04	Professional		$36.22	$52.32	$57.04
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 $49.30 / $65.01 / $102.69	Professional		$49.30	$65.01	$102.69