Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $318.77 / $1,544.00 / $6,432.00	Facility		$318.77	$1,544.00	$6,432.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $228.29 / $239.08 / $258.83	Facility	54	$228.29	$239.08	$258.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.30 / $313.70 / $580.52	Professional		$266.30	$313.70	$580.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $515.30 / $515.30 / $515.30	Professional		$515.30	$515.30	$515.30
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 $335.59 / $470.68 / $580.84	Professional		$335.59	$470.68	$580.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $520.98 / $520.98 / $520.98	Facility		$520.98	$520.98	$520.98
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $364.69 / $364.69 / $364.69	Facility	54	$364.69	$364.69	$364.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $282.70 / $377.88 / $619.41	Professional		$282.70	$377.88	$619.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $403.11 / $543.09 / $696.27	Professional		$403.11	$543.09	$696.27
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $692.45 / $1,075.70 / $2,495.76	Facility		$692.45	$1,075.70	$2,495.76
Highmark BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $343.33 / $343.33 / $1,005.72	Facility	54	$343.33	$343.33	$1,005.72
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $303.58 / $341.12 / $382.87	Professional		$303.58	$341.12	$382.87
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $335.51 / $1,569.00 / $7,197.00	Facility		$335.51	$1,569.00	$7,197.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $239.08 / $239.08 / $258.83	Facility	54	$239.08	$239.08	$258.83
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $272.79 / $359.99 / $753.60	Professional		$272.79	$359.99	$753.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $361.40 / $361.40 / $694.60	Professional		$361.40	$361.40	$694.60
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $520.98 / $520.98 / $520.98	Facility		$520.98	$520.98	$520.98
Priority Health Facility/Professional Facility Modifier 54 Low / Median / High Price $364.69 / $364.69 / $364.69	Facility	54	$364.69	$364.69	$364.69
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $288.88 / $380.77 / $634.47	Professional		$288.88	$380.77	$634.47
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $248.75 / $299.45 / $323.48	Facility		$248.75	$299.45	$323.48
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $292.49 / $316.41 / $347.32	Professional		$292.49	$316.41	$347.32
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 $284.38 / $384.22 / $599.60	Professional		$284.38	$384.22	$599.60