Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.30 / $399.60 / $3,447.91	Facility		$173.30	$399.60	$3,447.91
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $384.94 / $1,092.00 / $7,580.82	Facility	50	$384.94	$1,092.00	$7,580.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.85 / $119.48 / $251.95	Professional		$53.85	$119.48	$251.95
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $209.00 / $272.67 / $540.23	Professional	50	$209.00	$272.67	$540.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.69 / $86.69 / $86.69	Professional		$86.69	$86.69	$86.69
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 $133.35 / $188.57 / $249.80	Professional		$133.35	$188.57	$249.80
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $200.02 / $282.85 / $374.69	Professional	50	$200.02	$282.85	$374.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.12 / $116.79 / $248.58	Professional		$61.12	$116.79	$248.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $184.16 / $244.55 / $249.95	Professional		$184.16	$244.55	$249.95
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $184.84 / $374.45 / $724.38	Facility		$184.84	$374.45	$724.38
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $127.60 / $362.60 / $5,159.77	Facility	50	$127.60	$362.60	$5,159.77
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $173.93 / $540.44 / $5,342.00	Facility		$173.93	$540.44	$5,342.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $163.08 / $1,092.00 / $3,783.76	Facility	50	$163.08	$1,092.00	$3,783.76
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $55.30 / $135.09 / $276.70	Professional		$55.30	$135.09	$276.70
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $129.19 / $272.67 / $348.22	Professional	50	$129.19	$272.67	$348.22
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $141.69 / $428.00	Professional		$5.00	$141.69	$428.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $61.73 / $120.20 / $248.58	Professional		$61.73	$120.20	$248.58
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $55.76 / $70.53 / $152.50	Facility		$55.76	$70.53	$152.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $55.76 / $108.45 / $164.68	Professional		$55.76	$108.45	$164.68
United Facility/Professional Facility Modifier Low / Median / High Price $162.00 / $577.00 / $3,742.00	Facility		$162.00	$577.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $97.07 / $162.10 / $298.12	Professional		$97.07	$162.10	$298.12