Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.72 / $3,839.00 / $8,113.00	Facility		$253.72	$3,839.00	$8,113.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $119.47 / $126.86 / $126.86	Facility	52	$119.47	$126.86	$126.86
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 $273.83 / $526.00 / $2,269.00	Facility		$273.83	$526.00	$2,269.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $213.26 / $213.26 / $213.26	Facility	52	$213.26	$213.26	$213.26
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $26.66 / $26.66 / $26.66	Facility	AS	$26.66	$26.66	$26.66
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $532.08 / $532.08 / $532.08	Facility		$532.08	$532.08	$532.08
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $832.00 / $4,761.00 / $8,247.00	Facility		$832.00	$4,761.00	$8,247.00
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $126.86 / $126.86 / $126.86	Facility	52	$126.86	$126.86	$126.86
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $296.30 / $296.30 / $296.30	Facility		$296.30	$296.30	$296.30
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $273.83 / $526.00 / $2,269.00	Facility		$273.83	$526.00	$2,269.00
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $213.26 / $213.26 / $213.26	Facility	52	$213.26	$213.26	$213.26
Priority Health Facility/Professional Facility Modifier AS Low / Median / High Price $26.66 / $26.66 / $26.66	Facility	AS	$26.66	$26.66	$26.66
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $234.57 / $234.57 / $293.92	Facility		$234.57	$234.57	$293.92
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