Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $235.95 / $525.08 / $4,761.00	Facility		$235.95	$525.08	$4,761.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $140.11 / $149.47 / $399.10	Facility	54	$140.11	$149.47	$399.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.88 / $211.27 / $411.30	Professional		$165.88	$211.27	$411.30
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $127.65 / $149.40 / $287.42	Professional	54	$127.65	$149.40	$287.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.65 / $321.05 / $321.05	Professional		$167.65	$321.05	$321.05
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 $209.07 / $216.96 / $294.35	Professional		$209.07	$216.96	$294.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $329.43 / $329.43 / $329.43	Facility		$329.43	$329.43	$329.43
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $230.60 / $230.60 / $230.60	Facility	54	$230.60	$230.60	$230.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.28 / $230.41 / $379.70	Professional		$172.28	$230.41	$379.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $251.70 / $338.96 / $434.76	Professional		$251.70	$338.96	$434.76
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $284.50 / $630.20 / $1,332.08	Facility		$284.50	$630.20	$1,332.08
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $187.23 / $224.88 / $273.64	Professional		$187.23	$224.88	$273.64
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $221.82 / $1,301.00 / $5,958.00	Facility		$221.82	$1,301.00	$5,958.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $149.47 / $159.08 / $399.10	Facility	54	$149.47	$159.08	$399.10
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $175.37 / $264.52 / $433.69	Professional		$175.37	$264.52	$433.69
Martin's Point Facility/Professional Professional Modifier 54 Low / Median / High Price $131.87 / $165.76 / $307.89	Professional	54	$131.87	$165.76	$307.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $190.50 / $212.90 / $424.10	Professional		$190.50	$212.90	$424.10
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $329.43 / $329.43 / $329.43	Facility		$329.43	$329.43	$329.43
Priority Health Facility/Professional Facility Modifier 54 Low / Median / High Price $230.60 / $230.60 / $230.60	Facility	54	$230.60	$230.60	$230.60
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $173.12 / $236.15 / $387.25	Professional		$173.12	$236.15	$387.25
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $165.49 / $188.01 / $200.02	Facility		$165.49	$188.01	$200.02
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $178.44 / $195.88 / $215.11	Professional		$178.44	$195.88	$215.11
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 $173.50 / $234.80 / $366.43	Professional		$173.50	$234.80	$366.43