Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,715.35 / $14,791.08 / $33,884.42	Facility		$3,715.35	$14,791.08	$33,884.42
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,090.30 / $23,988.33 / $38,018.94	Facility	22	$3,090.30	$23,988.33	$38,018.94
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,248.07 / $26,915.35 / $63,095.73	Facility	50	$5,248.07	$26,915.35	$63,095.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,659.59 / $5,754.40	Professional		$831.76	$1,659.59	$5,754.40
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $169.82 / $331.13 / $954.99	Professional	AS	$169.82	$331.13	$954.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $1,202.26 / $1,995.26	Professional		$165.96	$1,202.26	$1,995.26
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 / $2,818.38	Professional		$1,288.25	$1,949.84	$2,818.38
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 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 $1,202.26 / $1,659.59 / $2,630.27	Professional		$1,202.26	$1,659.59	$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 / $2,630.27	Professional		$1,174.90	$1,584.89	$2,630.27
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $8,511.38 / $25,703.96 / $47,863.01	Facility		$8,511.38	$25,703.96	$47,863.01
Highmark BCBS Facility/Professional Facility Modifier 22 Low / Median / High Price $60,255.96 / $60,255.96 / $77,624.71	Facility	22	$60,255.96	$60,255.96	$77,624.71
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $7,943.28 / $23,442.29 / $87,096.36	Facility	50	$7,943.28	$23,442.29	$87,096.36
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,659.59 / $2,187.76	Professional		$1,445.44	$1,659.59	$2,187.76
Highmark BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $208.93 / $229.09 / $302.00	Professional	AS	$208.93	$229.09	$302.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $3,235.94 / $14,125.38 / $34,673.69	Facility		$3,235.94	$14,125.38	$34,673.69
Martin's Point Facility/Professional Facility Modifier 22 Low / Median / High Price $3,090.30 / $24,547.09 / $38,018.94	Facility	22	$3,090.30	$24,547.09	$38,018.94
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $7,244.36 / $22,908.68 / $56,234.13	Facility	50	$7,244.36	$22,908.68	$56,234.13
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,778.28 / $4,786.30	Professional		$1,148.15	$1,778.28	$4,786.30
Martin's Point Facility/Professional Professional Modifier AS Low / Median / High Price $169.82 / $331.13 / $977.24	Professional	AS	$169.82	$331.13	$977.24
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $2,238.72 / $2,570.40	Facility		$2,238.72	$2,238.72	$2,570.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,905.46 / $1,995.26 / $2,884.03	Professional		$1,905.46	$1,995.26	$2,884.03
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,041.74 / $2,630.27	Facility		$1,258.93	$2,041.74	$2,630.27
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $2,041.74 / $2,630.27	Professional		$1,258.93	$2,041.74	$2,630.27
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 / $1,621.81 / $2,691.53	Professional		$1,174.90	$1,621.81	$2,691.53