Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $2,691.53 / $8,317.64	Facility		$588.84	$2,691.53	$8,317.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $151.36 / $338.84	Professional		$107.15	$151.36	$338.84
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $114.82 / $194.98 / $316.23	Professional	54	$114.82	$194.98	$316.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $190.55	Professional		$97.72	$125.89	$190.55
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $69.18 / $69.18 / $69.18	Professional	54	$69.18	$69.18	$69.18
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $1,258.93 / $57,543.99	Facility		$1,174.90	$1,258.93	$57,543.99
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $181.97 / $208.93	Professional		$165.96	$181.97	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $144.54 / $144.54 / $144.54	Facility	54	$144.54	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $144.54 / $239.88	Professional		$107.15	$144.54	$239.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $213.80 / $269.15	Professional		$154.88	$213.80	$269.15
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $151.36 / $234.42	Professional		$97.72	$151.36	$234.42
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $724.44 / $1,380.38	Facility		$389.05	$724.44	$1,380.38
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $128.82 / $147.91	Professional		$117.49	$128.82	$147.91
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $2,089.30 / $7,762.47	Facility		$537.03	$2,089.30	$7,762.47
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $158.49 / $331.13	Professional		$109.65	$158.49	$331.13
Martin's Point Facility/Professional Professional Modifier 54 Low / Median / High Price $134.90 / $204.17 / $323.59	Professional	54	$134.90	$204.17	$323.59
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $251.19	Facility		$131.83	$131.83	$251.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $165.96 / $275.42	Professional		$138.04	$165.96	$275.42
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $117.49 / $131.83	Facility		$53.70	$117.49	$131.83
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $117.49 / $309.03	Professional		$53.70	$117.49	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $676.08 / $3,890.45	Facility		$223.87	$676.08	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $134.90 / $223.87	Professional		$102.33	$134.90	$223.87