Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.93 / $517.03 / $3,839.00	Facility		$139.93	$517.03	$3,839.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.42 / $129.41 / $276.87	Professional		$68.42	$129.41	$276.87
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,845.86 / $3,024.89 / $15,181.11	Facility		$1,845.86	$3,024.89	$15,181.11
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $134.99 / $134.99 / $134.99	Professional		$134.99	$134.99	$134.99
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,083.51 / $1,395.00 / $5,044.89	Facility		$1,083.51	$1,395.00	$5,044.89
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $124.07 / $142.86 / $252.86	Professional		$124.07	$142.86	$252.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $126.19 / $233.30	Professional		$77.84	$126.19	$233.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $194.08 / $200.41 / $277.11	Professional		$194.08	$200.41	$277.11
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $264.48 / $498.42 / $870.19	Facility		$264.48	$498.42	$870.19
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.02 / $78.02 / $78.02	Professional		$78.02	$78.02	$78.02
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $254.53 / $2,934.86 / $7,252.25	Facility		$254.53	$2,934.86	$7,252.25
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $130.16 / $130.16 / $151.19	Professional		$130.16	$130.16	$151.19
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $153.97 / $949.70 / $5,350.00	Facility		$153.97	$949.70	$5,350.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $70.19 / $142.66 / $276.87	Professional		$70.19	$142.66	$276.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $6.00 / $151.50 / $346.20	Professional		$6.00	$151.50	$346.20
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $78.92 / $129.08 / $248.88	Professional		$78.92	$129.08	$248.88
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $66.19 / $86.70 / $128.75	Facility		$66.19	$86.70	$128.75
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $66.19 / $123.27 / $135.19	Professional		$66.19	$123.27	$135.19
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 $108.23 / $147.02 / $237.79	Professional		$108.23	$147.02	$237.79