Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $266.33 / $641.00 / $5,750.00	Facility		$266.33	$641.00	$5,750.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $222.95 / $241.10 / $251.78	Facility	54	$222.95	$241.10	$251.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.51 / $314.70 / $603.23	Professional		$275.51	$314.70	$603.23
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 $324.50 / $392.42 / $566.40	Professional		$324.50	$392.42	$566.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $528.76 / $528.76 / $528.76	Facility		$528.76	$528.76	$528.76
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $370.13 / $370.13 / $370.13	Facility	54	$370.13	$370.13	$370.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $278.89 / $369.78 / $614.97	Professional		$278.89	$369.78	$614.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $388.15 / $522.98 / $670.43	Professional		$388.15	$522.98	$670.43
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $257.00 / $1,172.36 / $2,294.82	Facility		$257.00	$1,172.36	$2,294.82
Highmark BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $804.57 / $804.57 / $804.57	Facility	54	$804.57	$804.57	$804.57
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $325.12 / $335.58 / $416.50	Professional		$325.12	$335.58	$416.50
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $473.66 / $1,777.00 / $7,763.00	Facility		$473.66	$1,777.00	$7,763.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $241.10 / $241.10 / $251.78	Facility	54	$241.10	$241.10	$251.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $276.06 / $359.95 / $765.94	Professional		$276.06	$359.95	$765.94
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $399.70 / $399.70 / $668.50	Professional		$399.70	$399.70	$668.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $528.76 / $528.76 / $528.76	Facility		$528.76	$528.76	$528.76
Priority Health Facility/Professional Facility Modifier 54 Low / Median / High Price $370.13 / $370.13 / $370.13	Facility	54	$370.13	$370.13	$370.13
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $282.05 / $377.92 / $636.38	Professional		$282.05	$377.92	$636.38
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $303.52 / $307.11 / $343.35	Facility		$303.52	$307.11	$343.35
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $302.83 / $314.57 / $337.77	Professional		$302.83	$314.57	$337.77
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 $279.45 / $382.64 / $632.65	Professional		$279.45	$382.64	$632.65