Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $109.65	Facility		$79.43	$79.43	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $199.53	Professional		$69.18	$97.72	$199.53
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 $107.15 / $112.20 / $181.97	Professional		$107.15	$112.20	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $109.65 / $190.55	Professional		$74.13	$109.65	$190.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $190.55 / $245.47	Professional		$141.25	$190.55	$245.47
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $138.04 / $204.17	Professional		$91.20	$138.04	$204.17
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $109.65	Facility		$79.43	$79.43	$109.65
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $120.23 / $263.03	Professional		$75.86	$120.23	$263.03
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $218.78	Facility		$138.04	$138.04	$218.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $131.83 / $239.88	Professional		$120.23	$131.83	$239.88
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $6.76 / $54.95 / $91.20	Facility		$6.76	$54.95	$91.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $75.86 / $107.15	Professional		$38.90	$75.86	$107.15
United Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $758.58 / $3,890.45	Facility		$223.87	$758.58	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $177.83	Professional		$72.44	$107.15	$177.83