Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $832.00 / $2,329.98 / $5,668.08	Facility		$832.00	$2,329.98	$5,668.08
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $79.51 / $79.51 / $617.91	Facility	52	$79.51	$79.51	$617.91
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $31.80 / $31.80 / $247.16	Facility	53	$31.80	$31.80	$247.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.96 / $241.13 / $1,235.82	Professional		$143.96	$241.13	$1,235.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $127.48 / $164.91 / $857.77	Professional		$127.48	$164.91	$857.77
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,298.89 / $3,148.48 / $13,170.50	Facility		$2,298.89	$3,148.48	$13,170.50
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,344.69 / $3,159.00 / $14,886.03	Facility		$2,344.69	$3,159.00	$14,886.03
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $980.53 / $1,017.53 / $1,904.50	Professional		$980.53	$1,017.53	$1,904.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $429.00 / $1,235.59 / $2,434.58	Facility		$429.00	$1,235.59	$2,434.58
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $206.22 / $206.22 / $206.22	Facility	52	$206.22	$206.22	$206.22
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $51.55 / $51.55 / $51.55	Facility	53	$51.55	$51.55	$51.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.13 / $298.10 / $1,768.46	Professional		$160.13	$298.10	$1,768.46
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $334.72 / $334.72 / $334.72	Facility		$334.72	$334.72	$334.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $237.50 / $1,209.89 / $1,718.37	Professional		$237.50	$1,209.89	$1,718.37
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,253.19 / $3,750.87 / $6,869.81	Facility		$1,253.19	$3,750.87	$6,869.81
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $4,380.59 / $4,380.59 / $4,380.59	Facility	52	$4,380.59	$4,380.59	$4,380.59
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.44 / $194.22 / $296.39	Professional		$176.44	$194.22	$296.39
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,931.66 / $3,001.19 / $10,615.90	Facility		$1,931.66	$3,001.19	$10,615.90
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $611.70 / $2,664.47 / $6,155.00	Facility		$611.70	$2,664.47	$6,155.00
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $79.51 / $79.51 / $617.91	Facility	52	$79.51	$79.51	$617.91
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $31.80 / $31.80 / $247.16	Facility	53	$31.80	$31.80	$247.16
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $147.36 / $334.60 / $1,779.00	Professional		$147.36	$334.60	$1,779.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $216.90 / $216.90 / $216.90	Facility		$216.90	$216.90	$216.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $211.23 / $305.60 / $2,470.19	Professional		$211.23	$305.60	$2,470.19
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $257.77 / $1,225.90 / $2,316.65	Facility		$257.77	$1,225.90	$2,316.65
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $206.22 / $206.22 / $206.22	Facility	52	$206.22	$206.22	$206.22
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $51.55 / $51.55 / $51.55	Facility	53	$51.55	$51.55	$51.55
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $163.38 / $299.48 / $1,721.79	Professional		$163.38	$299.48	$1,721.79
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $148.34 / $182.29 / $1,039.61	Facility		$148.34	$182.29	$1,039.61
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $148.34 / $304.02 / $1,136.53	Professional		$148.34	$304.02	$1,136.53
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 $176.52 / $1,109.13 / $1,978.14	Professional		$176.52	$1,109.13	$1,978.14