Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $216.75 / $1,544.00 / $7,175.00	Facility		$216.75	$1,544.00	$7,175.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $147.22 / $149.96 / $166.25	Facility	54	$147.22	$149.96	$166.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $176.38 / $203.53 / $375.63	Professional		$176.38	$203.53	$375.63
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 $215.48 / $223.61 / $223.61	Professional		$215.48	$223.61	$223.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $328.64 / $328.64 / $328.64	Facility		$328.64	$328.64	$328.64
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $230.05 / $230.05 / $230.05	Facility	54	$230.05	$230.05	$230.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.30 / $243.97 / $403.90	Professional		$186.30	$243.97	$403.90
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $257.81 / $344.65 / $445.30	Professional		$257.81	$344.65	$445.30
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $538.79 / $613.87 / $1,246.35	Facility		$538.79	$613.87	$1,246.35
Highmark BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $159.07 / $159.07 / $159.07	Facility	54	$159.07	$159.07	$159.07
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $166.33 / $223.27 / $275.19	Professional		$166.33	$223.27	$275.19
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $216.75 / $1,544.00 / $7,197.00	Facility		$216.75	$1,544.00	$7,197.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $149.96 / $149.96 / $166.25	Facility	54	$149.96	$149.96	$166.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $177.66 / $227.71 / $474.01	Professional		$177.66	$227.71	$474.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $290.30 / $290.30 / $467.10	Professional		$290.30	$290.30	$467.10
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $328.64 / $328.64 / $328.64	Facility		$328.64	$328.64	$328.64
Priority Health Facility/Professional Facility Modifier 54 Low / Median / High Price $230.05 / $230.05 / $230.05	Facility	54	$230.05	$230.05	$230.05
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $188.21 / $245.72 / $407.39	Professional		$188.21	$245.72	$407.39
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $187.74 / $207.03 / $260.17	Facility		$187.74	$207.03	$260.17
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $186.68 / $204.72 / $221.94	Professional		$186.68	$204.72	$221.94
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 $189.10 / $264.36 / $420.54	Professional		$189.10	$264.36	$420.54