Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $242.85 / $1,284.00 / $6,012.00	Facility		$242.85	$1,284.00	$6,012.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $165.89 / $165.89 / $189.66	Facility	54	$165.89	$165.89	$189.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.05 / $234.25 / $426.20	Professional		$195.05	$234.25	$426.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $280.98 / $280.98 / $280.98	Professional		$280.98	$280.98	$280.98
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 $244.55 / $253.78 / $423.66	Professional		$244.55	$253.78	$423.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $362.57 / $362.57 / $362.57	Facility		$362.57	$362.57	$362.57
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $253.80 / $253.80 / $253.80	Facility	54	$253.80	$253.80	$253.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.01 / $270.61 / $448.18	Professional		$203.01	$270.61	$448.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $293.27 / $393.31 / $506.58	Professional		$293.27	$393.31	$506.58
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $284.55 / $612.36 / $1,107.86	Facility		$284.55	$612.36	$1,107.86
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $235.62 / $258.11 / $313.57	Professional		$235.62	$258.11	$313.57
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $379.00 / $1,978.00 / $7,799.00	Facility		$379.00	$1,978.00	$7,799.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $165.89 / $165.89 / $189.66	Facility	54	$165.89	$165.89	$189.66
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $201.06 / $264.74 / $520.92	Professional		$201.06	$264.74	$520.92
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $301.51 / $331.10 / $506.40	Professional		$301.51	$331.10	$506.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $362.57 / $362.57 / $362.57	Facility		$362.57	$362.57	$362.57
Priority Health Facility/Professional Facility Modifier 54 Low / Median / High Price $253.80 / $253.80 / $253.80	Facility	54	$253.80	$253.80	$253.80
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $204.78 / $275.02 / $451.39	Professional		$204.78	$275.02	$451.39
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $208.02 / $232.42 / $266.70	Facility		$208.02	$232.42	$266.70
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $207.13 / $231.80 / $253.84	Professional		$207.13	$231.80	$253.84
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 $203.03 / $284.38 / $466.90	Professional		$203.03	$284.38	$466.90