Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $379.00 / $2,070.00 / $7,197.00	Facility		$379.00	$2,070.00	$7,197.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $167.65 / $186.86 / $189.80	Facility	54	$167.65	$186.86	$189.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.78 / $231.88 / $407.43	Professional		$200.78	$231.88	$407.43
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 $245.53 / $254.79 / $415.50	Professional		$245.53	$254.79	$415.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $409.29 / $409.29 / $409.29	Facility		$409.29	$409.29	$409.29
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $286.50 / $286.50 / $286.50	Facility	54	$286.50	$286.50	$286.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.01 / $276.16 / $460.38	Professional		$198.01	$276.16	$460.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $294.52 / $397.58 / $508.73	Professional		$294.52	$397.58	$508.73
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.07 / $194.07 / $281.68	Professional		$194.07	$194.07	$281.68
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 $186.86 / $186.86 / $189.80	Facility	54	$186.86	$186.86	$189.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $201.12 / $249.14 / $521.29	Professional		$201.12	$249.14	$521.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $267.10 / $267.10 / $504.00	Professional		$267.10	$267.10	$504.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $409.29 / $409.29 / $409.29	Facility		$409.29	$409.29	$409.29
Priority Health Facility/Professional Facility Modifier 54 Low / Median / High Price $286.50 / $286.50 / $286.50	Facility	54	$286.50	$286.50	$286.50
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $209.27 / $277.95 / $473.97	Professional		$209.27	$277.95	$473.97
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $189.29 / $235.74 / $259.49	Facility		$189.29	$235.74	$259.49
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $230.62 / $237.78 / $255.83	Professional		$230.62	$237.78	$255.83
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 $200.34 / $273.92 / $456.67	Professional		$200.34	$273.92	$456.67