Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $605.00 / $2,952.82 / $7,799.00	Facility		$605.00	$2,952.82	$7,799.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $115.79 / $115.79 / $409.35	Facility	52	$115.79	$115.79	$409.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.53 / $616.70 / $1,098.88	Professional		$218.53	$616.70	$1,098.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.11 / $198.84 / $320.14	Professional		$105.11	$198.84	$320.14
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 $681.92 / $1,002.83 / $1,328.81	Professional		$681.92	$1,002.83	$1,328.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $491.00 / $1,640.38 / $3,263.44	Facility		$491.00	$1,640.38	$3,263.44
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $302.02 / $302.02 / $302.02	Facility	52	$302.02	$302.02	$302.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $249.54 / $500.65 / $1,202.17	Professional		$249.54	$500.65	$1,202.17
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $488.80 / $488.80 / $488.80	Facility		$488.80	$488.80	$488.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $831.75 / $1,102.90 / $1,409.17	Professional		$831.75	$1,102.90	$1,409.17
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,450.00 / $4,949.31 / $9,096.04	Facility		$1,450.00	$4,949.31	$9,096.04
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $2,441.59 / $2,441.59 / $2,441.59	Facility	52	$2,441.59	$2,441.59	$2,441.59
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $257.06 / $284.98 / $443.51	Professional		$257.06	$284.98	$443.51
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $594.00 / $3,623.00 / $7,936.23	Facility		$594.00	$3,623.00	$7,936.23
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $115.79 / $115.79 / $409.35	Facility	52	$115.79	$115.79	$409.35
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $221.44 / $683.06 / $1,363.99	Professional		$221.44	$683.06	$1,363.99
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $812.50 / $812.50 / $812.50	Facility		$812.50	$812.50	$812.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $812.50 / $2,064.40	Professional		$5.00	$812.50	$2,064.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $377.53 / $1,627.50 / $3,263.44	Facility		$377.53	$1,627.50	$3,263.44
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $302.02 / $302.02 / $302.02	Facility	52	$302.02	$302.02	$302.02
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $510.66 / $1,168.09	Professional		$250.00	$510.66	$1,168.09
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $216.41 / $272.49 / $762.44	Facility		$216.41	$272.49	$762.44
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $216.41 / $694.84 / $764.09	Professional		$216.41	$694.84	$764.09
United Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $1,734.00 / $4,300.00	Facility		$550.00	$1,734.00	$4,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $624.08 / $826.91 / $1,377.39	Professional		$624.08	$826.91	$1,377.39