Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.70 / $281.49 / $698.24	Facility		$67.70	$281.49	$698.24
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $192.20 / $192.20 / $366.96	Facility	50	$192.20	$192.20	$366.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.15 / $66.94 / $155.24	Professional		$39.15	$66.94	$155.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $88.56 / $114.57 / $114.57	Professional	50	$88.56	$114.57	$114.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.12 / $103.42 / $118.35	Professional		$76.12	$103.42	$118.35
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $663.55 / $3,204.33 / $6,163.25	Facility		$663.55	$3,204.33	$6,163.25
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 $67.34 / $96.14 / $138.04	Professional		$67.34	$96.14	$138.04
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $101.03 / $144.63 / $207.10	Professional	50	$101.03	$144.63	$207.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.02 / $68.02 / $68.02	Facility		$68.02	$68.02	$68.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.65 / $67.93 / $118.40	Professional		$40.65	$67.93	$118.40
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $81.25 / $108.85 / $140.33	Professional		$81.25	$108.85	$140.33
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $140.41 / $300.00 / $405.68	Facility		$140.41	$300.00	$405.68
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $282.70 / $282.70 / $282.70	Facility	50	$282.70	$282.70	$282.70
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.75 / $75.34 / $81.03	Professional		$64.75	$75.34	$81.03
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $136.66 / $136.66 / $136.66	Professional	50	$136.66	$136.66	$136.66
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $168.99 / $2,887.47 / $6,163.25	Facility		$168.99	$2,887.47	$6,163.25
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $59.49 / $281.49 / $1,062.00	Facility		$59.49	$281.49	$1,062.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $192.20 / $215.80 / $1,638.00	Facility	50	$192.20	$215.80	$1,638.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $39.52 / $70.87 / $135.27	Professional		$39.52	$70.87	$135.27
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $88.56 / $88.56 / $114.57	Professional	50	$88.56	$88.56	$114.57
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $819.61 / $1,003.93 / $1,042.19	Facility		$819.61	$1,003.93	$1,042.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $61.79 / $76.12 / $141.90	Professional		$61.79	$76.12	$141.90
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $68.02 / $68.02 / $68.02	Facility		$68.02	$68.02	$68.02
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $41.19 / $68.88 / $118.46	Professional		$41.19	$68.88	$118.46
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $39.29 / $39.39 / $64.28	Facility		$39.29	$39.39	$64.28
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $60.06 / $69.31	Professional		$39.29	$60.06	$69.31
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 $56.35 / $75.31 / $120.97	Professional		$56.35	$75.31	$120.97