Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $324.02 / $1,583.00 / $7,175.00	Facility		$324.02	$1,583.00	$7,175.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $235.19 / $243.02 / $266.77	Facility	54	$235.19	$243.02	$266.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $273.62 / $321.31 / $540.53	Professional		$273.62	$321.31	$540.53
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 $345.41 / $358.45 / $599.59	Professional		$345.41	$358.45	$599.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $528.16 / $528.16 / $528.16	Facility		$528.16	$528.16	$528.16
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $369.72 / $369.72 / $369.72	Facility	54	$369.72	$369.72	$369.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $289.27 / $386.20 / $629.61	Professional		$289.27	$386.20	$629.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $415.22 / $558.82 / $717.19	Professional		$415.22	$558.82	$717.19
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $294.00 / $738.00 / $2,294.82	Facility		$294.00	$738.00	$2,294.82
Highmark BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $213.60 / $213.60 / $213.60	Facility	54	$213.60	$213.60	$213.60
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $298.75 / $351.47 / $414.08	Professional		$298.75	$351.47	$414.08
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $313.57 / $1,569.00 / $7,763.00	Facility		$313.57	$1,569.00	$7,763.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $243.02 / $243.02 / $266.77	Facility	54	$243.02	$243.02	$266.77
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $279.83 / $358.07 / $710.14	Professional		$279.83	$358.07	$710.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $387.50 / $387.50 / $721.00	Professional		$387.50	$387.50	$721.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $528.16 / $528.16 / $528.16	Facility		$528.16	$528.16	$528.16
Priority Health Facility/Professional Facility Modifier 54 Low / Median / High Price $369.72 / $369.72 / $369.72	Facility	54	$369.72	$369.72	$369.72
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $297.07 / $390.64 / $637.97	Professional		$297.07	$390.64	$637.97
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $281.85 / $303.56 / $339.06	Facility		$281.85	$303.56	$339.06
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $296.77 / $325.42 / $357.07	Professional		$296.77	$325.42	$357.07
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 $293.75 / $402.37 / $653.45	Professional		$293.75	$402.37	$653.45