Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.83 / $464.12 / $3,340.00	Facility		$100.83	$464.12	$3,340.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $682.84 / $1,994.00 / $3,477.53	Facility	50	$682.84	$1,994.00	$3,477.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.03 / $96.96 / $224.38	Professional		$57.03	$96.96	$224.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $126.15 / $224.13 / $609.00	Professional	50	$126.15	$224.13	$609.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.35 / $138.80 / $183.88	Professional		$87.35	$138.80	$183.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $142.05 / $166.98 / $275.82	Professional	50	$142.05	$166.98	$275.82
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $419.51 / $687.48 / $5,494.83	Facility		$419.51	$687.48	$5,494.83
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $103.54 / $109.81 / $181.53	Professional		$103.54	$109.81	$181.53
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 $97.46 / $142.09 / $167.89	Professional		$97.46	$142.09	$167.89
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $146.18 / $213.94 / $251.85	Professional	50	$146.18	$213.94	$251.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.78 / $100.78 / $100.78	Facility		$100.78	$100.78	$100.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.58 / $102.36 / $169.61	Professional		$63.58	$102.36	$169.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $115.85 / $155.10 / $200.11	Professional		$115.85	$155.10	$200.11
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $294.29 / $793.82 / $1,323.13	Facility		$294.29	$793.82	$1,323.13
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $579.05 / $1,287.06 / $1,984.69	Facility	50	$579.05	$1,287.06	$1,984.69
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.17 / $120.71 / $151.66	Professional		$92.17	$120.71	$151.66
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $148.37 / $187.37 / $227.49	Professional	50	$148.37	$187.37	$227.49
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $352.41 / $671.03 / $1,648.24	Facility		$352.41	$671.03	$1,648.24
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $101.11 / $109.81 / $217.09	Professional		$101.11	$109.81	$217.09
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $93.57 / $1,196.45 / $4,264.00	Facility		$93.57	$1,196.45	$4,264.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $707.52 / $1,132.33 / $3,477.53	Facility	50	$707.52	$1,132.33	$3,477.53
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $57.68 / $102.17 / $215.54	Professional		$57.68	$102.17	$215.54
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $130.62 / $219.32 / $580.50	Professional	50	$130.62	$219.32	$580.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $73.58 / $101.20 / $165.01	Professional		$73.58	$101.20	$165.01
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $100.78 / $100.78 / $100.78	Facility		$100.78	$100.78	$100.78
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $63.48 / $102.36 / $178.25	Professional		$63.48	$102.36	$178.25
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $58.62 / $68.50 / $99.19	Facility		$58.62	$68.50	$99.19
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $58.62 / $94.67 / $103.43	Professional		$58.62	$94.67	$103.43
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 $91.34 / $116.55 / $181.34	Professional		$91.34	$116.55	$181.34