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 $1,829.17 / $2,001.25 / $2,839.03	Professional		$1,829.17	$2,001.25	$2,839.03
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 $2,031.15 / $2,107.80 / $2,107.80	Professional		$2,031.15	$2,107.80	$2,107.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,293.52 / $2,293.52 / $2,293.52	Facility		$2,293.52	$2,293.52	$2,293.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,750.03 / $2,505.19 / $4,053.30	Professional		$1,750.03	$2,505.19	$4,053.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,388.94 / $3,227.79 / $4,126.34	Professional		$2,388.94	$3,227.79	$4,126.34
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 $1,829.17 / $2,108.69 / $6,862.00	Professional		$1,829.17	$2,108.69	$6,862.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,133.69 / $2,133.69 / $4,130.50	Professional		$2,133.69	$2,133.69	$4,130.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $2,293.52 / $2,293.52 / $2,293.52	Facility		$2,293.52	$2,293.52	$2,293.52
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,785.20 / $2,513.96 / $4,087.24	Professional		$1,785.20	$2,513.96	$4,087.24
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,805.18 / $1,986.73 / $1,986.73	Facility		$1,805.18	$1,986.73	$1,986.73
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,805.18 / $1,986.73 / $2,099.31	Professional		$1,805.18	$1,986.73	$2,099.31
United Facility/Professional Facility Modifier Low / Median / High Price $1,843.00 / $3,742.00 / $7,000.00	Facility		$1,843.00	$3,742.00	$7,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,816.65 / $2,479.48 / $3,887.52	Professional		$1,816.65	$2,479.48	$3,887.52