Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $657.00 / $3,097.50 / $13,557.01	Facility		$657.00	$3,097.50	$13,557.01
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $679.07 / $9,228.48 / $9,228.48	Facility	50	$679.07	$9,228.48	$9,228.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.81 / $659.11 / $2,185.06	Professional		$297.81	$659.11	$2,185.06
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $515.63 / $688.38 / $6,015.33	Professional	50	$515.63	$688.38	$6,015.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $129.25 / $275.37 / $585.77	Professional		$129.25	$275.37	$585.77
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $192.95 / $204.67 / $1,032.07	Professional	50	$192.95	$204.67	$1,032.07
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $3,343.84 / $4,423.43 / $21,884.15	Facility		$3,343.84	$4,423.43	$21,884.15
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $750.73 / $1,351.13 / $2,826.24	Professional		$750.73	$1,351.13	$2,826.24
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $1,126.17 / $2,026.70 / $4,239.37	Professional	50	$1,126.17	$2,026.70	$4,239.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.98 / $500.98 / $500.98	Facility		$500.98	$500.98	$500.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.91 / $661.67 / $2,757.36	Professional		$302.91	$661.67	$2,757.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,586.24 / $2,056.16 / $2,703.67	Professional		$1,586.24	$2,056.16	$2,703.67
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.50 / $2,608.57 / $5,524.15	Facility		$0.50	$2,608.57	$5,524.15
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,008.54 / $2,008.54 / $5,254.47	Facility	50	$2,008.54	$2,008.54	$5,254.47
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $353.51 / $387.72 / $414.54	Professional		$353.51	$387.72	$414.54
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $537.29 / $591.03 / $2,582.03	Professional	50	$537.29	$591.03	$2,582.03
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,809.68 / $4,399.84 / $21,750.30	Facility		$2,809.68	$4,399.84	$21,750.30
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $831.17 / $3,106.59 / $9,760.00	Facility		$831.17	$3,106.59	$9,760.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $679.07 / $4,400.00 / $9,228.48	Facility	50	$679.07	$4,400.00	$9,228.48
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $304.77 / $752.78 / $2,657.98	Professional		$304.77	$752.78	$2,657.98
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $515.63 / $688.38 / $2,332.66	Professional	50	$515.63	$688.38	$2,332.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $462.59 / $1,695.70 / $3,264.50	Professional		$462.59	$1,695.70	$3,264.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $335.96 / $500.98 / $500.98	Facility		$335.96	$500.98	$500.98
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $303.27 / $678.62 / $2,602.85	Professional		$303.27	$678.62	$2,602.85
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $287.85 / $373.80 / $1,365.03	Facility		$287.85	$373.80	$1,365.03
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $287.85 / $373.80 / $1,485.04	Professional		$287.85	$373.80	$1,485.04
United Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $780.00 / $3,742.00	Facility		$144.00	$780.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,172.90 / $1,821.02 / $3,105.61	Professional		$1,172.90	$1,821.02	$3,105.61