Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $310.70 / $939.00 / $5,750.00	Facility		$310.70	$939.00	$5,750.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $205.39 / $212.99 / $749.20	Facility	54	$205.39	$212.99	$749.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.30 / $279.55 / $515.55	Professional		$240.30	$279.55	$515.55
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 $302.29 / $358.93 / $522.30	Professional		$302.29	$358.93	$522.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $464.51 / $464.51 / $464.51	Facility		$464.51	$464.51	$464.51
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $325.16 / $325.16 / $325.16	Facility	54	$325.16	$325.16	$325.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.53 / $336.21 / $555.17	Professional		$251.53	$336.21	$555.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $363.31 / $489.38 / $627.53	Professional		$363.31	$489.38	$627.53
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $519.84 / $718.67 / $1,076.85	Facility		$519.84	$718.67	$1,076.85
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $307.04 / $325.47 / $384.66	Professional		$307.04	$325.47	$384.66
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $298.50 / $1,519.00 / $7,175.00	Facility		$298.50	$1,519.00	$7,175.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $212.99 / $233.03 / $749.20	Facility	54	$212.99	$233.03	$749.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $245.94 / $327.35 / $675.07	Professional		$245.94	$327.35	$675.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $298.50 / $298.50 / $624.29	Professional		$298.50	$298.50	$624.29
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $464.51 / $464.51 / $464.51	Facility		$464.51	$464.51	$464.51
Priority Health Facility/Professional Facility Modifier 54 Low / Median / High Price $325.16 / $325.16 / $325.16	Facility	54	$325.16	$325.16	$325.16
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $259.63 / $340.57 / $568.95	Professional		$259.63	$340.57	$568.95
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $240.18 / $266.77 / $291.12	Facility		$240.18	$266.77	$291.12
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $260.56 / $284.80 / $312.72	Professional		$260.56	$284.80	$312.72
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 $256.36 / $347.10 / $571.08	Professional		$256.36	$347.10	$571.08