Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $217.27 / $533.37 / $4,761.00	Facility		$217.27	$533.37	$4,761.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,283.90 / $1,283.90 / $1,283.90	Facility	50	$1,283.90	$1,283.90	$1,283.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.89 / $123.78 / $263.62	Professional		$46.89	$123.78	$263.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $88.16 / $126.39 / $126.39	Professional	50	$88.16	$126.39	$126.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.63 / $71.84 / $149.28	Professional		$44.63	$71.84	$149.28
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $522.48 / $691.16 / $4,388.85	Facility		$522.48	$691.16	$4,388.85
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $152.51 / $158.27 / $260.44	Professional		$152.51	$158.27	$260.44
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $228.77 / $237.40 / $390.66	Professional	50	$228.77	$237.40	$390.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.79 / $84.79 / $84.79	Facility		$84.79	$84.79	$84.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.30 / $152.08 / $283.45	Professional		$51.30	$152.08	$283.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $184.20 / $238.06 / $316.47	Professional		$184.20	$238.06	$316.47
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $304.17 / $428.55 / $887.82	Facility		$304.17	$428.55	$887.82
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $716.94 / $716.94 / $716.94	Facility	50	$716.94	$716.94	$716.94
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.17 / $59.59 / $126.21	Professional		$54.17	$59.59	$126.21
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $439.01 / $682.09 / $2,792.27	Facility		$439.01	$682.09	$2,792.27
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $155.65 / $693.30 / $5,627.00	Facility		$155.65	$693.30	$5,627.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $1,283.90 / $1,283.90 / $2,600.00	Facility	50	$1,283.90	$1,283.90	$2,600.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $49.04 / $127.22 / $291.52	Professional		$49.04	$127.22	$291.52
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $88.16 / $88.16 / $126.39	Professional	50	$88.16	$88.16	$126.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $377.10 / $406.80	Professional		$87.98	$377.10	$406.80
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $84.79 / $84.79 / $174.64	Facility		$84.79	$84.79	$174.64
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $52.92 / $152.08 / $277.95	Professional		$52.92	$152.08	$277.95
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $48.97 / $124.11 / $290.52	Facility		$48.97	$124.11	$290.52
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $48.97 / $156.78 / $172.06	Professional		$48.97	$156.78	$172.06
United Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $1,078.00 / $3,742.00	Facility		$144.00	$1,078.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $149.44 / $193.22 / $321.92	Professional		$149.44	$193.22	$321.92