Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,298.48 / $4,761.00 / $9,534.00	Facility		$1,298.48	$4,761.00	$9,534.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $608.37 / $649.24 / $649.24	Facility	52	$608.37	$649.24	$649.24
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $243.35 / $259.70 / $259.70	Facility	53	$243.35	$259.70	$259.70
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $13,531.00 / $27,840.00 / $46,296.00	Facility		$13,531.00	$27,840.00	$46,296.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $800.00 / $2,151.00	Facility		$500.00	$800.00	$2,151.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,091.32 / $1,091.32 / $1,091.32	Facility	52	$1,091.32	$1,091.32	$1,091.32
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $272.83 / $272.83 / $272.83	Facility	53	$272.83	$272.83	$272.83
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $136.41 / $136.41 / $136.41	Facility	AS	$136.41	$136.41	$136.41
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $2,735.33 / $2,735.33 / $2,735.33	Facility		$2,735.33	$2,735.33	$2,735.33
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,037.00 / $1,037.00 / $1,037.00	Facility		$1,037.00	$1,037.00	$1,037.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,013.00 / $5,342.00 / $9,534.00	Facility		$1,013.00	$5,342.00	$9,534.00
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $649.24 / $649.24 / $649.24	Facility	52	$649.24	$649.24	$649.24
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $259.70 / $259.70 / $259.70	Facility	53	$259.70	$259.70	$259.70
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,038.50 / $1,038.50 / $1,038.50	Facility		$1,038.50	$1,038.50	$1,038.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $500.00 / $800.00 / $2,151.00	Facility		$500.00	$800.00	$2,151.00
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $1,091.32 / $1,091.32 / $1,091.32	Facility	52	$1,091.32	$1,091.32	$1,091.32
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $272.83 / $272.83 / $272.83	Facility	53	$272.83	$272.83	$272.83
Priority Health Facility/Professional Facility Modifier AS Low / Median / High Price $136.41 / $136.41 / $136.41	Facility	AS	$136.41	$136.41	$136.41
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,193.31 / $1,193.31 / $1,300.70	Facility		$1,193.31	$1,193.31	$1,300.70
United Facility/Professional Facility Modifier Low / Median / High Price $388.00 / $2,020.00 / $6,322.00	Facility		$388.00	$2,020.00	$6,322.00