Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,288.25 / $6,165.95 / $9,549.93	Facility		$1,288.25	$6,165.95	$9,549.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,288.25 / $3,388.44	Professional		$1,122.02	$1,288.25	$3,388.44
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 $1,258.93 / $1,288.25 / $2,238.72	Professional		$1,258.93	$1,288.25	$2,238.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $2,137.96 / $2,137.96	Facility		$2,137.96	$2,137.96	$2,137.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,479.11 / $2,454.71	Professional		$1,071.52	$1,479.11	$2,454.71
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,041.74 / $2,630.27	Professional		$1,548.82	$2,041.74	$2,630.27
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,621.81 / $2,454.71	Professional		$1,148.15	$1,621.81	$2,454.71
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $5,248.07 / $9,549.93	Facility		$1,122.02	$5,248.07	$9,549.93
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,659.59 / $3,890.45	Professional		$1,148.15	$1,659.59	$3,890.45
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $2,511.89	Facility		$1,412.54	$1,412.54	$2,511.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,778.28 / $2,691.53	Professional		$1,288.25	$1,778.28	$2,691.53
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,230.27	Facility		$1,148.15	$1,148.15	$1,230.27
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,230.27 / $1,288.25	Professional		$1,148.15	$1,230.27	$1,288.25
United Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $5,495.41 / $22,387.21	Facility		$2,454.71	$5,495.41	$22,387.21
United Facility/Professional Professional Modifier Low / Median / High Price $1,071.52 / $1,412.54 / $2,398.83	Professional		$1,071.52	$1,412.54	$2,398.83