Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,447.00 / $6,501.52 / $10,889.24	Facility		$1,447.00	$6,501.52	$10,889.24
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $16,576.00 / $16,576.00 / $16,576.00	Facility	50	$16,576.00	$16,576.00	$16,576.00
Aetna Facility/Professional Facility Modifier AS Low / Median / High Price $18,770.88 / $18,770.88 / $18,770.88	Facility	AS	$18,770.88	$18,770.88	$18,770.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $451.63 / $616.09 / $2,497.48	Professional		$451.63	$616.09	$2,497.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $410.17 / $615.30 / $933.49	Professional		$410.17	$615.30	$933.49
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $4,013.94 / $6,010.73 / $50,162.48	Facility		$4,013.94	$6,010.73	$50,162.48
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $686.32 / $776.81 / $1,882.42	Professional		$686.32	$776.81	$1,882.42
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $4,150.00 / $8,639.91 / $15,468.00	Facility		$4,150.00	$8,639.91	$15,468.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $546.39 / $857.51 / $1,293.64	Professional		$546.39	$857.51	$1,293.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $618.99 / $618.99 / $618.99	Facility		$618.99	$618.99	$618.99
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $61.52 / $61.52 / $61.52	Facility	AS	$61.52	$61.52	$61.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $526.14 / $695.88 / $1,129.50	Professional		$526.14	$695.88	$1,129.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $692.06 / $876.25 / $1,456.56	Professional		$692.06	$876.25	$1,456.56
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,233.95 / $6,499.96 / $12,789.17	Facility		$3,233.95	$6,499.96	$12,789.17
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $5,377.40 / $5,377.40 / $6,237.54	Facility	50	$5,377.40	$5,377.40	$6,237.54
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $649.77 / $739.93 / $994.42	Professional		$649.77	$739.93	$994.42
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $3,403.08 / $5,729.54 / $14,618.96	Facility		$3,403.08	$5,729.54	$14,618.96
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $686.32 / $734.36 / $1,207.15	Professional		$686.32	$734.36	$1,207.15
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $954.00 / $6,072.00 / $11,037.25	Facility		$954.00	$6,072.00	$11,037.25
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $16,576.00 / $16,576.00 / $16,576.00	Facility	50	$16,576.00	$16,576.00	$16,576.00
Martin's Point Facility/Professional Facility Modifier AS Low / Median / High Price $18,770.88 / $18,770.88 / $18,770.88	Facility	AS	$18,770.88	$18,770.88	$18,770.88
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $487.92 / $709.52 / $2,228.21	Professional		$487.92	$709.52	$2,228.21
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $758.10 / $783.21 / $1,129.00	Professional		$758.10	$783.21	$1,129.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $618.99 / $618.99 / $618.99	Facility		$618.99	$618.99	$618.99
Priority Health Facility/Professional Facility Modifier AS Low / Median / High Price $61.52 / $61.52 / $61.52	Facility	AS	$61.52	$61.52	$61.52
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $526.14 / $699.44 / $1,152.31	Professional		$526.14	$699.44	$1,152.31
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $531.02 / $531.02 / $762.48	Facility		$531.02	$531.02	$762.48
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $515.67 / $532.60 / $762.48	Professional		$515.67	$532.60	$762.48
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $3,805.00 / $6,368.00	Facility		$2,155.00	$3,805.00	$6,368.00
United Facility/Professional Professional Modifier Low / Median / High Price $542.99 / $717.83 / $1,145.82	Professional		$542.99	$717.83	$1,145.82