Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $428.00 / $1,978.00 / $7,197.00	Facility		$428.00	$1,978.00	$7,197.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $216.34 / $233.02 / $244.23	Facility	54	$216.34	$233.02	$244.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $252.78 / $295.95 / $511.87	Professional		$252.78	$295.95	$511.87
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,344.69 / $3,159.00 / $14,886.03	Facility		$2,344.69	$3,159.00	$14,886.03
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $313.70 / $325.54 / $448.29	Professional		$313.70	$325.54	$448.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $506.07 / $506.07 / $506.07	Facility		$506.07	$506.07	$506.07
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $354.25 / $354.25 / $354.25	Facility	54	$354.25	$354.25	$354.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $258.79 / $355.79 / $589.84	Professional		$258.79	$355.79	$589.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $374.89 / $508.13 / $647.54	Professional		$374.89	$508.13	$647.54
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,110.00 / $1,110.00 / $1,110.00	Facility		$1,110.00	$1,110.00	$1,110.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.44 / $318.39 / $350.24	Professional		$224.44	$318.39	$350.24
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $617.00 / $2,266.00 / $8,017.00	Facility		$617.00	$2,266.00	$8,017.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $233.02 / $233.02 / $244.23	Facility	54	$233.02	$233.02	$244.23
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $252.78 / $316.88 / $764.30	Professional		$252.78	$316.88	$764.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $309.89 / $309.89 / $644.70	Professional		$309.89	$309.89	$644.70
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $506.07 / $506.07 / $506.07	Facility		$506.07	$506.07	$506.07
Priority Health Facility/Professional Facility Modifier 54 Low / Median / High Price $354.25 / $354.25 / $354.25	Facility	54	$354.25	$354.25	$354.25
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $259.33 / $361.98 / $604.91	Professional		$259.33	$361.98	$604.91
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $248.48 / $291.38 / $304.66	Facility		$248.48	$291.38	$304.66
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $283.22 / $296.44 / $325.49	Professional		$283.22	$296.44	$325.49
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 $263.33 / $350.88 / $568.37	Professional		$263.33	$350.88	$568.37