Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,677.35 / $12,302.69 / $37,153.52	Facility		$4,677.35	$12,302.69	$37,153.52
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $5,128.61 / $10,964.78 / $29,512.09	Facility	22	$5,128.61	$10,964.78	$29,512.09
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,456.54 / $50,118.72 / $63,095.73	Facility	50	$6,456.54	$50,118.72	$63,095.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $1,778.28 / $5,495.41	Professional		$549.54	$1,778.28	$5,495.41
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $158.49 / $338.84 / $933.25	Professional	AS	$158.49	$338.84	$933.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $1,230.27 / $2,187.76	Professional		$154.88	$1,230.27	$2,187.76
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $20,417.38 / $21,379.62 / $57,543.99	Facility		$20,417.38	$21,379.62	$57,543.99
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,949.84 / $2,754.23	Professional		$1,288.25	$1,949.84	$2,754.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $2,187.76 / $2,187.76	Facility		$2,187.76	$2,187.76	$2,187.76
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Facility	22	$2,630.27	$2,630.27	$2,630.27
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility	54	$1,513.56	$1,513.56	$1,513.56
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Facility	62	$1,380.38	$1,380.38	$1,380.38
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $218.78 / $218.78 / $218.78	Facility	AS	$218.78	$218.78	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,621.81 / $2,630.27	Professional		$1,174.90	$1,621.81	$2,630.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,862.09 / $2,398.83	Professional		$1,380.38	$1,862.09	$2,398.83
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,584.89 / $2,511.89	Professional		$1,174.90	$1,584.89	$2,511.89
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,317.64 / $25,703.96 / $47,863.01	Facility		$8,317.64	$25,703.96	$47,863.01
Highmark BCBS Facility/Professional Facility Modifier 22 Low / Median / High Price $12,022.64 / $12,022.64 / $23,442.29	Facility	22	$12,022.64	$12,022.64	$23,442.29
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $12,882.50 / $25,118.86 / $158,489.32	Facility	50	$12,882.50	$25,118.86	$158,489.32
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,513.56 / $1,659.59 / $2,089.30	Professional		$1,513.56	$1,659.59	$2,089.30
Highmark BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $208.93 / $229.09 / $263.03	Professional	AS	$208.93	$229.09	$263.03
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $12,302.69 / $37,153.52	Facility		$3,890.45	$12,302.69	$37,153.52
Martin's Point Facility/Professional Facility Modifier 22 Low / Median / High Price $5,128.61 / $10,964.78 / $29,512.09	Facility	22	$5,128.61	$10,964.78	$29,512.09
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $6,456.54 / $34,673.69 / $63,095.73	Facility	50	$6,456.54	$34,673.69	$63,095.73
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,819.70 / $4,677.35	Professional		$1,148.15	$1,819.70	$4,677.35
Martin's Point Facility/Professional Professional Modifier AS Low / Median / High Price $162.18 / $354.81 / $954.99	Professional	AS	$162.18	$354.81	$954.99
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,089.30 / $2,089.30 / $2,570.40	Facility		$2,089.30	$2,089.30	$2,570.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,905.46 / $2,884.03	Professional		$1,819.70	$1,905.46	$2,884.03
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,905.46 / $1,905.46	Facility		$1,258.93	$1,905.46	$1,905.46
UPMC Health Plan Facility/Professional Facility Modifier 62 Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Facility	62	$1,819.70	$1,819.70	$1,819.70
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $1,258.93 / $1,905.46	Professional		$691.83	$1,258.93	$1,905.46
United Facility/Professional Facility Modifier Low / Median / High Price $3,311.31 / $8,709.64 / $39,810.72	Facility		$3,311.31	$8,709.64	$39,810.72
United Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,584.89 / $2,630.27	Professional		$1,174.90	$1,584.89	$2,630.27