Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,426.00 / $3,830.00 / $8,240.00	Facility		$1,426.00	$3,830.00	$8,240.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,755.93 / $1,956.95 / $2,810.54	Professional		$1,755.93	$1,956.95	$2,810.54
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $13,531.00 / $27,840.00 / $46,296.00	Facility		$13,531.00	$27,840.00	$46,296.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,932.94 / $2,005.88 / $2,005.88	Professional		$1,932.94	$2,005.88	$2,005.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,204.04 / $2,204.04 / $2,204.04	Facility		$2,204.04	$2,204.04	$2,204.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,855.13 / $2,461.76 / $3,945.68	Professional		$1,855.13	$2,461.76	$3,945.68
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,256.05 / $3,022.95 / $3,896.81	Professional		$2,256.05	$3,022.95	$3,896.81
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,020.00 / $4,597.00 / $8,404.00	Facility		$1,020.00	$4,597.00	$8,404.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,755.93 / $2,079.88 / $6,862.00	Professional		$1,755.93	$2,079.88	$6,862.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,406.80 / $2,406.80 / $4,103.39	Professional		$2,406.80	$2,406.80	$4,103.39
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $2,204.04 / $2,204.04 / $2,204.04	Facility		$2,204.04	$2,204.04	$2,204.04
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,875.96 / $2,488.30 / $4,141.10	Professional		$1,875.96	$2,488.30	$4,141.10
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,908.34 / $1,908.34 / $3,006.60	Facility		$1,908.34	$1,908.34	$3,006.60
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,851.86 / $1,915.94 / $3,006.60	Professional		$1,851.86	$1,915.94	$3,006.60
United Facility/Professional Facility Modifier Low / Median / High Price $2,332.00 / $3,879.00 / $7,508.00	Facility		$2,332.00	$3,879.00	$7,508.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,848.48 / $2,365.34 / $3,791.00	Professional		$1,848.48	$2,365.34	$3,791.00