Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $228.82 / $884.68 / $5,750.00	Facility		$228.82	$884.68	$5,750.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $161.21 / $171.62 / $945.38	Facility	54	$161.21	$171.62	$945.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.40 / $226.97 / $452.45	Professional		$178.40	$226.97	$452.45
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $141.79 / $161.21 / $276.27	Professional	54	$141.79	$161.21	$276.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.26 / $311.43 / $381.43	Professional		$204.26	$311.43	$381.43
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 $221.51 / $229.87 / $302.77	Professional		$221.51	$229.87	$302.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $351.09 / $351.09 / $351.09	Facility		$351.09	$351.09	$351.09
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $245.76 / $245.76 / $245.76	Facility	54	$245.76	$245.76	$245.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.58 / $252.23 / $417.65	Professional		$193.58	$252.23	$417.65
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $265.29 / $354.63 / $458.22	Professional		$265.29	$354.63	$458.22
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $233.20 / $580.00 / $1,103.93	Facility		$233.20	$580.00	$1,103.93
Highmark BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $207.31 / $804.57 / $830.25	Facility	54	$207.31	$804.57	$830.25
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.83 / $249.55 / $289.50	Professional		$213.83	$249.55	$289.50
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $214.94 / $1,069.84 / $7,104.00	Facility		$214.94	$1,069.84	$7,104.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $161.21 / $171.62 / $945.38	Facility	54	$161.21	$171.62	$945.38
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $186.02 / $264.75 / $460.78	Professional		$186.02	$264.75	$460.78
Martin's Point Facility/Professional Professional Modifier 54 Low / Median / High Price $142.87 / $182.37 / $341.61	Professional	54	$142.87	$182.37	$341.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $270.89 / $292.42 / $458.70	Professional		$270.89	$292.42	$458.70
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $351.09 / $351.09 / $351.09	Facility		$351.09	$351.09	$351.09
Priority Health Facility/Professional Facility Modifier 54 Low / Median / High Price $245.76 / $245.76 / $245.76	Facility	54	$245.76	$245.76	$245.76
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $196.46 / $257.60 / $436.19	Professional		$196.46	$257.60	$436.19
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $201.33 / $213.98 / $267.95	Facility		$201.33	$213.98	$267.95
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $199.97 / $213.98 / $242.80	Professional		$199.97	$213.98	$242.80
United Facility/Professional Facility Modifier Low / Median / High Price $330.90 / $650.00 / $3,742.00	Facility		$330.90	$650.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $197.54 / $262.56 / $386.99	Professional		$197.54	$262.56	$386.99