Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $414.75 / $2,300.00 / $6,012.00	Facility		$414.75	$2,300.00	$6,012.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $91.73 / $211.16 / $1,262.00	Facility	52	$91.73	$211.16	$1,262.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $36.69 / $36.69 / $84.46	Facility	53	$36.69	$36.69	$84.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.52 / $270.00 / $550.52	Professional		$172.52	$270.00	$550.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.19 / $165.26 / $328.28	Professional		$128.19	$165.26	$328.28
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 $367.87 / $381.76 / $421.90	Professional		$367.87	$381.76	$421.90
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 $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $185.16 / $315.95 / $693.18	Professional		$185.16	$315.95	$693.18
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $384.68 / $384.68 / $384.68	Facility		$384.68	$384.68	$384.68
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $264.66 / $571.73 / $759.76	Professional		$264.66	$571.73	$759.76
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $885.18 / $1,928.46 / $3,513.48	Facility		$885.18	$1,928.46	$3,513.48
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $1,454.99 / $1,454.99 / $1,454.99	Facility	52	$1,454.99	$1,454.99	$1,454.99
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $202.80 / $223.32 / $328.96	Professional		$202.80	$223.32	$328.96
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $364.43 / $2,202.00 / $6,785.72	Facility		$364.43	$2,202.00	$6,785.72
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $91.73 / $563.24 / $1,383.50	Facility	52	$91.73	$563.24	$1,383.50
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $36.69 / $36.69 / $84.46	Facility	53	$36.69	$36.69	$84.46
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $174.19 / $364.23 / $796.58	Professional		$174.19	$364.23	$796.58
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $251.80 / $251.80 / $251.80	Facility		$251.80	$251.80	$251.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $356.00 / $1,053.40	Professional		$5.00	$356.00	$1,053.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $296.61 / $760.00 / $1,865.00	Facility		$296.61	$760.00	$1,865.00
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $188.46 / $324.63 / $693.18	Professional		$188.46	$324.63	$693.18
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $170.79 / $208.00 / $371.24	Facility		$170.79	$208.00	$371.24
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $170.79 / $345.89 / $399.51	Professional		$170.79	$345.89	$399.51
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 $194.80 / $383.06 / $700.69	Professional		$194.80	$383.06	$700.69