Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $240.35 / $1,519.00 / $6,012.00	Facility		$240.35	$1,519.00	$6,012.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $159.22 / $176.52 / $688.66	Facility	54	$159.22	$176.52	$688.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.47 / $234.88 / $484.83	Professional		$197.47	$234.88	$484.83
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 $232.12 / $338.61 / $401.76	Professional		$232.12	$338.61	$401.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $265.22 / $265.22 / $265.22	Facility		$265.22	$265.22	$265.22
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $183.20 / $183.20 / $183.20	Facility	54	$183.20	$183.20	$183.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.66 / $266.86 / $449.82	Professional		$193.66	$266.86	$449.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $278.60 / $376.30 / $481.21	Professional		$278.60	$376.30	$481.21
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.00 / $1,005.72 / $2,495.76	Facility		$257.00	$1,005.72	$2,495.76
Highmark BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $448.92 / $978.41 / $2,670.69	Facility	54	$448.92	$978.41	$2,670.69
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.54 / $248.90 / $298.10	Professional		$234.54	$248.90	$298.10
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $247.28 / $1,499.00 / $7,175.00	Facility		$247.28	$1,499.00	$7,175.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $176.52 / $180.26 / $688.66	Facility	54	$176.52	$180.26	$688.66
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $200.65 / $279.16 / $493.70	Professional		$200.65	$279.16	$493.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $243.30 / $243.30 / $469.10	Professional		$243.30	$243.30	$469.10
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $265.22 / $265.22 / $265.22	Facility		$265.22	$265.22	$265.22
Priority Health Facility/Professional Facility Modifier 54 Low / Median / High Price $183.20 / $183.20 / $183.20	Facility	54	$183.20	$183.20	$183.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $207.66 / $269.55 / $452.80	Professional		$207.66	$269.55	$452.80
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $193.94 / $222.77 / $227.51	Facility		$193.94	$222.77	$227.51
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $217.62 / $224.72 / $244.08	Professional		$217.62	$224.72	$244.08
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 $196.06 / $262.92 / $431.62	Professional		$196.06	$262.92	$431.62