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 $876.59 / $934.81 / $934.81	Facility	52	$876.59	$934.81	$934.81
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 $1,570.62 / $1,570.62 / $1,570.62	Facility	52	$1,570.62	$1,570.62	$1,570.62
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $196.33 / $196.33 / $196.33	Facility	AS	$196.33	$196.33	$196.33
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $3,925.95 / $3,925.95 / $3,925.95	Facility		$3,925.95	$3,925.95	$3,925.95
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 $934.81 / $934.81 / $934.81	Facility	52	$934.81	$934.81	$934.81
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,410.30 / $1,410.30 / $1,410.30	Facility		$1,410.30	$1,410.30	$1,410.30
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 $1,570.62 / $1,570.62 / $1,570.62	Facility	52	$1,570.62	$1,570.62	$1,570.62
Priority Health Facility/Professional Facility Modifier AS Low / Median / High Price $196.33 / $196.33 / $196.33	Facility	AS	$196.33	$196.33	$196.33
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,619.93 / $1,721.54 / $1,721.54	Facility		$1,619.93	$1,721.54	$1,721.54
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