Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $740.50 / $3,740.00 / $8,266.25	Facility		$740.50	$3,740.00	$8,266.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.47 / $340.00 / $992.41	Professional		$161.47	$340.00	$992.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.82 / $262.82 / $322.94	Professional		$42.82	$262.82	$322.94
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $4,556.27 / $6,010.73 / $15,240.38	Facility		$4,556.27	$6,010.73	$15,240.38
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $6,393.00 / $11,479.00 / $18,724.00	Facility		$6,393.00	$11,479.00	$18,724.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $171.16 / $277.88 / $1,265.74	Professional		$171.16	$277.88	$1,265.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $194.23 / $194.23 / $194.23	Facility		$194.23	$194.23	$194.23
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $19.01 / $19.01 / $19.01	Facility	AS	$19.01	$19.01	$19.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.54 / $262.27 / $938.41	Professional		$169.54	$262.27	$938.41
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $199.68 / $271.30 / $344.91	Professional		$199.68	$271.30	$344.91
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $448.09 / $2,984.57 / $4,213.74	Facility		$448.09	$2,984.57	$4,213.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.51 / $227.58 / $970.43	Professional		$197.51	$227.58	$970.43
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $3,687.71 / $5,805.77 / $15,147.17	Facility		$3,687.71	$5,805.77	$15,147.17
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $439.43 / $3,964.59 / $8,890.00	Facility		$439.43	$3,964.59	$8,890.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $163.37 / $289.91 / $1,270.06	Professional		$163.37	$289.91	$1,270.06
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $238.98 / $902.10 / $951.40	Professional		$238.98	$902.10	$951.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $194.23 / $194.23 / $194.23	Facility		$194.23	$194.23	$194.23
Priority Health Facility/Professional Facility Modifier AS Low / Median / High Price $19.01 / $19.01 / $19.01	Facility	AS	$19.01	$19.01	$19.01
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $169.54 / $256.35 / $938.41	Professional		$169.54	$256.35	$938.41
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $167.84 / $167.84 / $900.26	Facility		$167.84	$167.84	$900.26
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $161.56 / $169.84 / $900.26	Professional		$161.56	$169.84	$900.26
United Facility/Professional Facility Modifier Low / Median / High Price $162.00 / $1,181.00 / $6,337.00	Facility		$162.00	$1,181.00	$6,337.00
United Facility/Professional Professional Modifier Low / Median / High Price $174.39 / $251.06 / $740.35	Professional		$174.39	$251.06	$740.35