Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $374.34 / $1,013.00 / $6,012.00	Facility		$374.34	$1,013.00	$6,012.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $184.58 / $194.56 / $209.51	Facility	54	$184.58	$194.56	$209.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $215.47 / $265.25 / $562.26	Professional		$215.47	$265.25	$562.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $374.83 / $374.83 / $374.83	Professional		$374.83	$374.83	$374.83
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 $274.01 / $390.72 / $511.90	Professional		$274.01	$390.72	$511.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $428.72 / $428.72 / $428.72	Facility		$428.72	$428.72	$428.72
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $300.10 / $300.10 / $300.10	Facility	54	$300.10	$300.10	$300.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.06 / $301.58 / $504.08	Professional		$229.06	$301.58	$504.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $329.99 / $444.87 / $569.98	Professional		$329.99	$444.87	$569.98
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.38 / $544.27 / $1,384.84	Facility		$208.38	$544.27	$1,384.84
Highmark BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $844.80 / $844.80 / $844.80	Facility	54	$844.80	$844.80	$844.80
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $264.22 / $298.47 / $413.23	Professional		$264.22	$298.47	$413.23
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $379.00 / $1,741.00 / $7,799.00	Facility		$379.00	$1,741.00	$7,799.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $194.56 / $194.56 / $209.51	Facility	54	$194.56	$194.56	$209.51
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $221.68 / $321.02 / $580.54	Professional		$221.68	$321.02	$580.54
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $286.39 / $286.39 / $563.00	Professional		$286.39	$286.39	$563.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $428.72 / $428.72 / $428.72	Facility		$428.72	$428.72	$428.72
Priority Health Facility/Professional Facility Modifier 54 Low / Median / High Price $300.10 / $300.10 / $300.10	Facility	54	$300.10	$300.10	$300.10
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $231.66 / $308.70 / $506.14	Professional		$231.66	$308.70	$506.14
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $231.04 / $244.50 / $262.52	Facility		$231.04	$244.50	$262.52
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $239.18 / $257.12 / $282.31	Professional		$239.18	$257.12	$282.31
United Facility/Professional Facility Modifier Low / Median / High Price $330.90 / $650.00 / $3,742.00	Facility		$330.90	$650.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $231.11 / $313.75 / $512.50	Professional		$231.11	$313.75	$512.50