Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $440.70 / $1,665.43 / $5,627.00	Facility		$440.70	$1,665.43	$5,627.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $49.18 / $242.94 / $1,069.89	Facility	52	$49.18	$242.94	$1,069.89
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.67 / $97.18 / $4,530.25	Facility	53	$19.67	$97.18	$4,530.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.62 / $301.72 / $569.51	Professional		$81.62	$301.72	$569.51
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.04 / $30.04 / $30.04	Professional		$30.04	$30.04	$30.04
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $3,736.00 / $4,444.00 / $15,949.31	Facility		$3,736.00	$4,444.00	$15,949.31
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $311.58 / $516.13 / $658.51	Professional		$311.58	$516.13	$658.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.50 / $203.47 / $633.82	Professional		$90.50	$203.47	$633.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $572.30 / $572.30 / $593.83	Professional		$572.30	$572.30	$593.83
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $937.60 / $3,106.04 / $4,944.14	Facility		$937.60	$3,106.04	$4,944.14
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $2,554.92 / $2,627.57 / $4,452.91	Facility	52	$2,554.92	$2,627.57	$4,452.91
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $440.70 / $2,070.00 / $5,958.00	Facility		$440.70	$2,070.00	$5,958.00
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $49.18 / $1,004.59 / $1,069.89	Facility	52	$49.18	$1,004.59	$1,069.89
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $19.67 / $97.18 / $4,530.25	Facility	53	$19.67	$97.18	$4,530.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $83.87 / $301.54 / $918.31	Professional		$83.87	$301.54	$918.31
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $466.00 / $1,083.59	Professional		$4.00	$466.00	$1,083.59
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $93.05 / $203.47 / $630.03	Professional		$93.05	$203.47	$630.03
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $81.79 / $95.92 / $420.60	Facility		$81.79	$95.92	$420.60
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $81.79 / $95.92 / $402.06	Professional		$81.79	$95.92	$402.06
United Facility/Professional Facility Modifier Low / Median / High Price $814.00 / $2,391.00 / $4,789.00	Facility		$814.00	$2,391.00	$4,789.00
United Facility/Professional Professional Modifier Low / Median / High Price $377.76 / $480.83 / $767.73	Professional		$377.76	$480.83	$767.73