Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,301.00 / $3,839.00 / $8,113.00	Facility		$1,301.00	$3,839.00	$8,113.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $823.83 / $879.35 / $879.35	Facility	52	$823.83	$879.35	$879.35
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 $1,471.60 / $1,471.60 / $1,471.60	Facility	52	$1,471.60	$1,471.60	$1,471.60
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $183.95 / $183.95 / $183.95	Facility	AS	$183.95	$183.95	$183.95
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $3,677.31 / $3,677.31 / $3,677.31	Facility		$3,677.31	$3,677.31	$3,677.31
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,013.00 / $4,761.00 / $8,247.00	Facility		$1,013.00	$4,761.00	$8,247.00
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $879.35 / $879.35 / $879.35	Facility	52	$879.35	$879.35	$879.35
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,516.10 / $1,516.10 / $1,516.10	Facility		$1,516.10	$1,516.10	$1,516.10
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 $1,471.60 / $1,471.60 / $1,471.60	Facility	52	$1,471.60	$1,471.60	$1,471.60
Priority Health Facility/Professional Facility Modifier AS Low / Median / High Price $183.95 / $183.95 / $183.95	Facility	AS	$183.95	$183.95	$183.95
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,546.72 / $1,613.10 / $1,613.10	Facility		$1,546.72	$1,613.10	$1,613.10
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