Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.40 / $226.68 / $473.93	Facility		$82.40	$226.68	$473.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $186.20 / $224.33 / $779.38	Facility	50	$186.20	$224.33	$779.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.59 / $74.75 / $146.53	Professional		$25.59	$74.75	$146.53
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $38.11 / $137.72 / $282.00	Professional	50	$38.11	$137.72	$282.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $88.80 / $88.80 / $88.80	Professional		$88.80	$88.80	$88.80
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,911.11 / $1,911.11 / $1,911.11	Facility		$1,911.11	$1,911.11	$1,911.11
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 $84.46 / $105.38 / $150.05	Professional		$84.46	$105.38	$150.05
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $126.69 / $158.94 / $225.11	Professional	50	$126.69	$158.94	$225.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.65 / $45.65 / $45.65	Facility		$45.65	$45.65	$45.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.83 / $79.68 / $141.38	Professional		$25.83	$79.68	$141.38
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $101.49 / $133.94 / $175.29	Professional		$101.49	$133.94	$175.29
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $122.00 / $316.11 / $568.03	Facility		$122.00	$316.11	$568.03
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $186.37 / $474.16 / $852.06	Facility	50	$186.37	$474.16	$852.06
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.95 / $81.52 / $88.20	Professional		$24.95	$81.52	$88.20
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $37.43 / $125.07 / $139.88	Professional	50	$37.43	$125.07	$139.88
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,911.11 / $1,911.11 / $2,421.23	Facility		$1,911.11	$1,911.11	$2,421.23
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $57.21 / $295.45 / $481.69	Facility		$57.21	$295.45	$481.69
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $186.20 / $442.22 / $891.97	Facility	50	$186.20	$442.22	$891.97
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $26.96 / $79.78 / $151.81	Professional		$26.96	$79.78	$151.81
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $32.94 / $136.49 / $422.00	Professional	50	$32.94	$136.49	$422.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.13 / $100.50 / $145.50	Professional		$33.13	$100.50	$145.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $45.65 / $45.65 / $45.65	Facility		$45.65	$45.65	$45.65
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $25.83 / $79.68 / $142.05	Professional		$25.83	$79.68	$142.05
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $26.33 / $55.77 / $85.77	Facility		$26.33	$55.77	$85.77
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $84.36 / $92.59	Professional		$26.26	$84.36	$92.59
United Facility/Professional Facility Modifier Low / Median / High Price $217.66 / $507.88 / $3,742.00	Facility		$217.66	$507.88	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $80.76 / $102.77 / $172.30	Professional		$80.76	$102.77	$172.30