Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $350.89 / $1,590.24 / $5,350.00	Facility		$350.89	$1,590.24	$5,350.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $747.75 / $1,624.47 / $4,532.60	Facility	50	$747.75	$1,624.47	$4,532.60
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $57.00 / $175.45 / $570.44	Facility	52	$57.00	$175.45	$570.44
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $22.80 / $64.94 / $70.18	Facility	53	$22.80	$64.94	$70.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.66 / $175.61 / $614.79	Professional		$95.66	$175.61	$614.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $156.66 / $178.28 / $178.28	Professional		$156.66	$178.28	$178.28
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,845.86 / $3,024.89 / $9,985.48	Facility		$1,845.86	$3,024.89	$9,985.48
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,299.82 / $2,746.00 / $13,822.74	Facility		$2,299.82	$2,746.00	$13,822.74
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $262.64 / $459.95 / $1,193.35	Professional		$262.64	$459.95	$1,193.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.43 / $268.61 / $757.33	Professional		$123.43	$268.61	$757.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $359.65 / $476.11 / $492.29	Professional		$359.65	$476.11	$492.29
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $785.04 / $1,399.11 / $2,592.08	Facility		$785.04	$1,399.11	$2,592.08
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,554.44 / $2,176.37 / $2,338.77	Facility	50	$1,554.44	$2,176.37	$2,338.77
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $619.16 / $619.16 / $684.90	Facility	52	$619.16	$619.16	$684.90
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $709.25 / $2,934.86 / $6,352.94	Facility		$709.25	$2,934.86	$6,352.94
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $428.00 / $1,604.58 / $5,526.00	Facility		$428.00	$1,604.58	$5,526.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $747.75 / $1,225.95 / $4,532.60	Facility	50	$747.75	$1,225.95	$4,532.60
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $57.00 / $175.45 / $570.44	Facility	52	$57.00	$175.45	$570.44
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $22.80 / $70.18 / $1,205.20	Facility	53	$22.80	$70.18	$1,205.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $96.65 / $215.44 / $664.86	Professional		$96.65	$215.44	$664.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $211.00 / $1,479.60	Professional		$4.00	$211.00	$1,479.60
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $123.43 / $275.83 / $766.28	Professional		$123.43	$275.83	$766.28
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $103.11 / $106.46 / $562.44	Facility		$103.11	$106.46	$562.44
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $103.24 / $300.89 / $329.01	Professional		$103.24	$300.89	$329.01
United Facility/Professional Facility Modifier Low / Median / High Price $471.00 / $1,305.00 / $3,742.00	Facility		$471.00	$1,305.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $276.29 / $482.51 / $777.58	Professional		$276.29	$482.51	$777.58