Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $153.97 / $594.00 / $5,350.00	Facility		$153.97	$594.00	$5,350.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $33.47 / $94.86 / $103.08	Facility	52	$33.47	$94.86	$103.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.09 / $185.02 / $406.00	Professional		$64.09	$185.02	$406.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $31.53 / $86.68 / $153.61	Professional	52	$31.53	$86.68	$153.61
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $208.39 / $208.39 / $208.39	Professional		$208.39	$208.39	$208.39
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 $161.94 / $299.02 / $389.46	Professional		$161.94	$299.02	$389.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.31 / $179.04 / $345.32	Professional		$72.31	$179.04	$345.32
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $105.52 / $114.00 / $297.52	Professional		$105.52	$114.00	$297.52
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $457.40 / $687.20 / $1,120.78	Facility		$457.40	$687.20	$1,120.78
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $253.75 / $253.75 / $253.75	Professional		$253.75	$253.75	$253.75
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $208.39 / $208.39 / $233.40	Professional		$208.39	$208.39	$233.40
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $210.66 / $1,637.46 / $7,799.00	Facility		$210.66	$1,637.46	$7,799.00
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $33.47 / $103.08 / $1,142.01	Facility	52	$33.47	$103.08	$1,142.01
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $65.34 / $189.72 / $418.51	Professional		$65.34	$189.72	$418.51
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $31.53 / $89.07 / $190.07	Professional	52	$31.53	$89.07	$190.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $78.97 / $142.00 / $491.90	Professional		$78.97	$142.00	$491.90
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $185.89 / $365.35	Professional		$72.44	$185.89	$365.35
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $63.36 / $121.57 / $187.50	Facility		$63.36	$121.57	$187.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $63.36 / $179.97 / $197.75	Professional		$63.36	$179.97	$197.75
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 $147.90 / $224.18 / $376.12	Professional		$147.90	$224.18	$376.12