Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $148.16 / $511.50 / $2,747.00	Facility		$148.16	$511.50	$2,747.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $240.14 / $464.12 / $2,410.75	Facility	50	$240.14	$464.12	$2,410.75
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $23.12 / $23.12 / $33.61	Facility	52	$23.12	$23.12	$33.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.18 / $74.04 / $228.00	Professional		$43.18	$74.04	$228.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.08 / $130.53 / $315.60	Professional	50	$66.08	$130.53	$315.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.63 / $85.28 / $109.79	Professional		$60.63	$85.28	$109.79
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $93.67 / $139.72 / $181.89	Professional	50	$93.67	$139.72	$181.89
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $419.51 / $687.48 / $3,961.09	Facility		$419.51	$687.48	$3,961.09
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $67.09 / $72.92 / $166.30	Professional		$67.09	$72.92	$166.30
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 $64.27 / $95.01 / $142.86	Professional		$64.27	$95.01	$142.86
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $96.40 / $142.50 / $214.28	Professional	50	$96.40	$142.50	$214.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.04 / $77.04 / $77.04	Facility		$77.04	$77.04	$77.04
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $61.63 / $61.63 / $61.63	Facility	52	$61.63	$61.63	$61.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.25 / $71.01 / $116.28	Professional		$47.25	$71.01	$116.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $81.76 / $102.89 / $158.13	Professional		$81.76	$102.89	$158.13
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $266.45 / $680.83 / $1,192.92	Facility		$266.45	$680.83	$1,192.92
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $334.78 / $1,059.57 / $1,984.69	Facility	50	$334.78	$1,059.57	$1,984.69
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $28.64 / $257.33 / $1,046.89	Facility	52	$28.64	$257.33	$1,046.89
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.43 / $81.91 / $104.05	Professional		$62.43	$81.91	$104.05
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $106.70 / $124.46 / $155.69	Professional	50	$106.70	$124.46	$155.69
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $352.41 / $671.03 / $1,705.93	Facility		$352.41	$671.03	$1,705.93
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $66.54 / $72.84 / $159.44	Professional		$66.54	$72.84	$159.44
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $85.28 / $717.49 / $3,103.00	Facility		$85.28	$717.49	$3,103.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $257.13 / $1,156.10 / $2,441.88	Facility	50	$257.13	$1,156.10	$2,441.88
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $23.12 / $23.12 / $33.61	Facility	52	$23.12	$23.12	$33.61
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $43.19 / $75.20 / $172.80	Professional		$43.19	$75.20	$172.80
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $68.36 / $128.74 / $258.66	Professional	50	$68.36	$128.74	$258.66
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $483.95 / $500.08 / $1,759.00	Facility		$483.95	$500.08	$1,759.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $59.70 / $71.40 / $124.10	Professional		$59.70	$71.40	$124.10
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $77.04 / $77.04 / $77.04	Facility		$77.04	$77.04	$77.04
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $61.63 / $61.63 / $61.63	Facility	52	$61.63	$61.63	$61.63
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $47.25 / $70.95 / $116.51	Professional		$47.25	$70.95	$116.51
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $44.05 / $48.19 / $73.69	Facility		$44.05	$48.19	$73.69
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $44.05 / $61.16 / $66.72	Professional		$44.05	$61.16	$66.72
United Facility/Professional Facility Modifier Low / Median / High Price $162.00 / $1,181.00 / $6,368.00	Facility		$162.00	$1,181.00	$6,368.00
United Facility/Professional Professional Modifier Low / Median / High Price $58.66 / $78.30 / $124.14	Professional		$58.66	$78.30	$124.14
United Facility/Professional Professional Modifier 50 Low / Median / High Price $80.00 / $80.00 / $80.00	Professional	50	$80.00	$80.00	$80.00