Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $343.67 / $538.20 / $2,747.00	Facility		$343.67	$538.20	$2,747.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $257.75 / $269.50 / $844.37	Facility	54	$257.75	$269.50	$844.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.37 / $356.77 / $688.99	Professional		$257.37	$356.77	$688.99
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,038.72 / $1,038.72 / $1,038.72	Professional	50	$1,038.72	$1,038.72	$1,038.72
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $219.58 / $257.75 / $430.55	Professional	54	$219.58	$257.75	$430.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $268.14 / $536.28 / $658.94	Professional		$268.14	$536.28	$658.94
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 $349.24 / $508.42 / $593.41	Professional		$349.24	$508.42	$593.41
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $523.86 / $762.63 / $916.88	Professional	50	$523.86	$762.63	$916.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $560.70 / $560.70 / $560.70	Facility		$560.70	$560.70	$560.70
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $392.49 / $392.49 / $392.49	Facility	54	$392.49	$392.49	$392.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $262.12 / $377.85 / $618.63	Professional		$262.12	$377.85	$618.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $421.03 / $566.41 / $727.23	Professional		$421.03	$566.41	$727.23
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $280.27 / $544.27 / $1,155.98	Facility		$280.27	$544.27	$1,155.98
Highmark BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $274.07 / $929.57 / $1,079.00	Facility	54	$274.07	$929.57	$1,079.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $319.86 / $370.02 / $477.16	Professional		$319.86	$370.02	$477.16
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $504.08 / $544.85 / $894.95	Professional	50	$504.08	$544.85	$894.95
Highmark BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $238.08 / $238.08 / $243.88	Professional	54	$238.08	$238.08	$243.88
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $352.62 / $786.84 / $5,627.00	Facility		$352.62	$786.84	$5,627.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $257.75 / $688.83 / $844.37	Facility	54	$257.75	$688.83	$844.37
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $275.92 / $418.50 / $702.33	Professional		$275.92	$418.50	$702.33
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $1,038.72 / $1,038.72 / $1,038.72	Professional	50	$1,038.72	$1,038.72	$1,038.72
Martin's Point Facility/Professional Professional Modifier 54 Low / Median / High Price $226.82 / $329.55 / $465.98	Professional	54	$226.82	$329.55	$465.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $314.80 / $381.00 / $719.40	Professional		$314.80	$381.00	$719.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $560.70 / $560.70 / $560.70	Facility		$560.70	$560.70	$560.70
Priority Health Facility/Professional Facility Modifier 54 Low / Median / High Price $392.49 / $392.49 / $392.49	Facility	54	$392.49	$392.49	$392.49
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $270.14 / $384.71 / $629.08	Professional		$270.14	$384.71	$629.08
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $269.69 / $321.67 / $336.21	Facility		$269.69	$321.67	$336.21
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $296.58 / $329.56 / $362.08	Professional		$296.58	$329.56	$362.08
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 $275.43 / $378.89 / $657.17	Professional		$275.43	$378.89	$657.17