Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $540.00 / $1,947.69 / $6,432.00	Facility		$540.00	$1,947.69	$6,432.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $134.25 / $134.25 / $370.55	Facility	52	$134.25	$134.25	$370.55
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $53.70 / $53.70 / $148.22	Facility	53	$53.70	$53.70	$148.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.65 / $563.69 / $880.28	Professional		$255.65	$563.69	$880.28
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.72 / $312.68 / $480.70	Professional		$218.72	$312.68	$480.70
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,772.00 / $2,838.15 / $8,459.92	Facility		$1,772.00	$2,838.15	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $627.60 / $651.29 / $651.29	Professional		$627.60	$651.29	$651.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $434.63 / $905.03 / $1,865.00	Facility		$434.63	$905.03	$1,865.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $347.70 / $347.70 / $347.70	Facility	52	$347.70	$347.70	$347.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $86.93 / $86.93 / $86.93	Facility	53	$86.93	$86.93	$86.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.70 / $563.11 / $1,121.46	Professional		$276.70	$563.11	$1,121.46
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $561.94 / $561.94 / $561.94	Facility		$561.94	$561.94	$561.94
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $546.25 / $782.02 / $1,117.17	Professional		$546.25	$782.02	$1,117.17
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,220.55 / $2,674.72 / $5,285.03	Facility		$1,220.55	$2,674.72	$5,285.03
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $318.57 / $389.42 / $507.34	Professional		$318.57	$389.42	$507.34
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $637.27 / $2,381.00 / $7,197.00	Facility		$637.27	$2,381.00	$7,197.00
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $134.25 / $134.25 / $370.55	Facility	52	$134.25	$134.25	$370.55
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $53.70 / $53.70 / $148.22	Facility	53	$53.70	$53.70	$148.22
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $268.49 / $608.62 / $1,402.17	Professional		$268.49	$608.62	$1,402.17
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $606.20 / $1,501.67 / $1,501.67	Facility		$606.20	$1,501.67	$1,501.67
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $336.49 / $693.10 / $1,466.80	Professional		$336.49	$693.10	$1,466.80
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $434.63 / $897.93 / $1,865.00	Facility		$434.63	$897.93	$1,865.00
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $347.70 / $347.70 / $347.70	Facility	52	$347.70	$347.70	$347.70
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $86.93 / $86.93 / $86.93	Facility	53	$86.93	$86.93	$86.93
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $276.73 / $563.11 / $1,121.46	Professional		$276.73	$563.11	$1,121.46
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $250.05 / $419.00 / $786.50	Facility		$250.05	$419.00	$786.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $250.05 / $634.30 / $694.82	Professional		$250.05	$634.30	$694.82
United Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $1,728.00 / $4,300.00	Facility		$550.00	$1,728.00	$4,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $571.66 / $751.61 / $1,288.43	Professional		$571.66	$751.61	$1,288.43