Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $484.72 / $3,839.00 / $9,968.17	Facility		$484.72	$3,839.00	$9,968.17
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $163.56 / $171.60 / $471.50	Facility	52	$163.56	$171.60	$471.50
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $65.42 / $68.64 / $68.64	Facility	53	$65.42	$68.64	$68.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $319.85 / $472.50 / $624.00	Professional		$319.85	$472.50	$624.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $310.05 / $546.12 / $546.12	Professional		$310.05	$546.12	$546.12
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,102.54 / $3,024.89 / $31,694.43	Facility		$2,102.54	$3,024.89	$31,694.43
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $3,736.00 / $4,444.00 / $15,949.31	Facility		$3,736.00	$4,444.00	$15,949.31
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $326.55 / $338.88 / $626.41	Professional		$326.55	$338.88	$626.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $491.00 / $1,998.88 / $3,938.52	Facility		$491.00	$1,998.88	$3,938.52
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $291.99 / $291.99 / $291.99	Facility	52	$291.99	$291.99	$291.99
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $73.00 / $73.00 / $73.00	Facility	53	$73.00	$73.00	$73.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.56 / $404.48 / $731.91	Professional		$263.56	$404.48	$731.91
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $719.50 / $719.50 / $719.50	Facility		$719.50	$719.50	$719.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $379.20 / $501.45 / $663.61	Professional		$379.20	$501.45	$663.61
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,581.75 / $6,583.44 / $11,082.49	Facility		$1,581.75	$6,583.44	$11,082.49
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $337.11 / $438.92 / $641.74	Professional		$337.11	$438.92	$641.74
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,102.54 / $3,024.89 / $23,267.55	Facility		$2,102.54	$3,024.89	$23,267.55
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $574.00 / $3,839.00 / $8,959.60	Facility		$574.00	$3,839.00	$8,959.60
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $171.60 / $171.60 / $471.50	Facility	52	$171.60	$171.60	$471.50
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $68.64 / $68.64 / $68.64	Facility	53	$68.64	$68.64	$68.64
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $327.11 / $472.50 / $1,350.66	Professional		$327.11	$472.50	$1,350.66
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $447.70 / $4,492.77 / $4,492.77	Facility		$447.70	$4,492.77	$4,492.77
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $463.70 / $823.60	Professional		$4.00	$463.70	$823.60
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $373.67 / $1,983.20 / $3,747.73	Facility		$373.67	$1,983.20	$3,747.73
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $291.99 / $291.99 / $291.99	Facility	52	$291.99	$291.99	$291.99
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $73.00 / $73.00 / $73.00	Facility	53	$73.00	$73.00	$73.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $275.83 / $397.17 / $696.59	Professional		$275.83	$397.17	$696.59
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $321.01 / $321.01 / $382.46	Facility		$321.01	$321.01	$382.46
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $311.20 / $322.66 / $382.46	Professional		$311.20	$322.66	$382.46
United Facility/Professional Facility Modifier Low / Median / High Price $550.00 / $1,734.00 / $4,300.00	Facility		$550.00	$1,734.00	$4,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $300.36 / $406.26 / $668.42	Professional		$300.36	$406.26	$668.42