Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $817.37 / $2,074.48 / $6,086.56	Facility		$817.37	$2,074.48	$6,086.56
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $71.52 / $886.41 / $2,054.57	Facility	52	$71.52	$886.41	$2,054.57
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.61 / $28.61 / $83.79	Facility	53	$28.61	$28.61	$83.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.56 / $221.72 / $665.95	Professional		$77.56	$221.72	$665.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.19 / $160.69 / $257.12	Professional		$90.19	$160.69	$257.12
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $501.24 / $2,919.62 / $5,761.96	Facility		$501.24	$2,919.62	$5,761.96
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $170.06 / $184.67 / $298.14	Professional		$170.06	$184.67	$298.14
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,772.00 / $2,454.00 / $8,459.92	Facility		$1,772.00	$2,454.00	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $356.86 / $370.33 / $370.33	Professional		$356.86	$370.33	$370.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $429.00 / $774.37 / $1,504.84	Facility		$429.00	$774.37	$1,504.84
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $185.70 / $185.70 / $185.70	Facility	52	$185.70	$185.70	$185.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $46.42 / $46.42 / $46.42	Facility	53	$46.42	$46.42	$46.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.29 / $317.52 / $618.66	Professional		$154.29	$317.52	$618.66
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $301.50 / $301.50 / $301.50	Facility		$301.50	$301.50	$301.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $290.06 / $459.39 / $616.17	Professional		$290.06	$459.39	$616.17
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $895.00 / $1,893.49 / $3,299.57	Facility		$895.00	$1,893.49	$3,299.57
Highmark BCBS Facility/Professional Facility Modifier 22 Low / Median / High Price $1,015.97 / $1,015.97 / $1,018.33	Facility	22	$1,015.97	$1,015.97	$1,018.33
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $433.75 / $1,056.98 / $2,104.42	Facility	52	$433.75	$1,056.98	$2,104.42
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.27 / $183.64 / $269.17	Professional		$158.27	$183.64	$269.17
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $450.98 / $2,637.64 / $5,778.74	Facility		$450.98	$2,637.64	$5,778.74
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $170.06 / $184.67 / $294.72	Professional		$170.06	$184.67	$294.72
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $651.25 / $1,946.30 / $5,350.00	Facility		$651.25	$1,946.30	$5,350.00
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $71.52 / $886.41 / $2,054.57	Facility	52	$71.52	$886.41	$2,054.57
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $28.61 / $28.61 / $83.79	Facility	53	$28.61	$28.61	$83.79
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $81.97 / $284.20 / $787.43	Professional		$81.97	$284.20	$787.43
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $336.90 / $336.90 / $336.90	Facility		$336.90	$336.90	$336.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $189.58 / $391.70 / $830.50	Professional		$189.58	$391.70	$830.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $232.12 / $760.00 / $1,865.00	Facility		$232.12	$760.00	$1,865.00
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $185.70 / $185.70 / $185.70	Facility	52	$185.70	$185.70	$185.70
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $46.42 / $46.42 / $46.42	Facility	53	$46.42	$46.42	$46.42
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $155.12 / $334.00 / $596.59	Professional		$155.12	$334.00	$596.59
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $133.53 / $244.96 / $374.05	Facility		$133.53	$244.96	$374.05
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $133.53 / $358.69 / $393.31	Professional		$133.53	$358.69	$393.31
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 $310.36 / $413.03 / $724.84	Professional		$310.36	$413.03	$724.84