Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $290.92 / $1,819.00 / $6,432.00	Facility		$290.92	$1,819.00	$6,432.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $45.67 / $45.67 / $145.46	Facility	52	$45.67	$45.67	$145.46
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $18.27 / $18.27 / $58.18	Facility	53	$18.27	$18.27	$58.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.14 / $192.56 / $326.83	Professional		$86.14	$192.56	$326.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.26 / $128.69 / $128.69	Professional		$78.26	$128.69	$128.69
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,772.00 / $2,838.15 / $8,459.92	Facility		$1,772.00	$2,838.15	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $232.68 / $251.14 / $260.61	Professional		$232.68	$251.14	$260.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $320.00 / $719.77 / $1,418.21	Facility		$320.00	$719.77	$1,418.21
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	52	$118.08	$118.08	$118.08
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.52 / $29.52 / $29.52	Facility	53	$29.52	$29.52	$29.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.11 / $210.00 / $408.50	Professional		$98.11	$210.00	$408.50
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $193.37 / $193.37 / $193.37	Facility		$193.37	$193.37	$193.37
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $304.74 / $407.55 / $520.79	Professional		$304.74	$407.55	$520.79
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,250.73 / $2,250.73 / $2,928.11	Facility		$2,250.73	$2,250.73	$2,928.11
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.60 / $112.08 / $133.90	Professional		$101.60	$112.08	$133.90
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $490.00 / $2,070.00 / $7,197.00	Facility		$490.00	$2,070.00	$7,197.00
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $45.67 / $45.67 / $145.46	Facility	52	$45.67	$45.67	$145.46
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $18.27 / $18.27 / $58.18	Facility	53	$18.27	$18.27	$58.18
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $89.59 / $237.64 / $622.55	Professional		$89.59	$237.64	$622.55
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $332.80 / $332.80 / $332.80	Facility		$332.80	$332.80	$332.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $93.10 / $332.80 / $611.60	Professional		$93.10	$332.80	$611.60
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $147.60 / $714.12 / $1,404.00	Facility		$147.60	$714.12	$1,404.00
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	52	$118.08	$118.08	$118.08
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $29.52 / $29.52 / $29.52	Facility	53	$29.52	$29.52	$29.52
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $98.11 / $212.92 / $407.70	Professional		$98.11	$212.92	$407.70
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $84.91 / $190.91 / $600.42	Facility		$84.91	$190.91	$600.42
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $84.91 / $251.26 / $276.22	Professional		$84.91	$251.26	$276.22
United Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $1,728.00 / $4,300.00	Facility		$550.00	$1,728.00	$4,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $281.30 / $454.09	Professional		$204.17	$281.30	$454.09