Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $366.73 / $1,743.17 / $4,810.00	Facility		$366.73	$1,743.17	$4,810.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $54.67 / $161.37 / $1,509.92	Facility	52	$54.67	$161.37	$1,509.92
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $21.87 / $21.87 / $64.55	Facility	53	$21.87	$21.87	$64.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.14 / $206.65 / $492.48	Professional		$97.14	$206.65	$492.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.79 / $108.18 / $194.56	Professional		$90.79	$108.18	$194.56
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,845.86 / $3,001.19 / $7,506.07	Facility		$1,845.86	$3,001.19	$7,506.07
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $108.31 / $108.31 / $111.59	Professional		$108.31	$108.31	$111.59
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,299.82 / $2,746.00 / $13,822.74	Facility		$2,299.82	$2,746.00	$13,822.74
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $277.38 / $408.03 / $588.27	Professional		$277.38	$408.03	$588.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $446.00 / $719.77 / $1,418.21	Facility		$446.00	$719.77	$1,418.21
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $143.59 / $143.59 / $143.59	Facility	52	$143.59	$143.59	$143.59
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $35.90 / $35.90 / $35.90	Facility	53	$35.90	$35.90	$35.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.75 / $234.87 / $510.06	Professional		$115.75	$234.87	$510.06
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $230.71 / $230.71 / $230.71	Facility		$230.71	$230.71	$230.71
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $335.85 / $444.82 / $568.34	Professional		$335.85	$444.82	$568.34
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,057.20 / $2,121.67 / $3,877.39	Facility		$1,057.20	$2,121.67	$3,877.39
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $997.93 / $997.93 / $997.93	Facility	52	$997.93	$997.93	$997.93
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.66 / $114.38 / $189.46	Professional		$91.66	$114.38	$189.46
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,229.20 / $2,952.51 / $5,134.47	Facility		$1,229.20	$2,952.51	$5,134.47
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $108.31 / $108.31 / $111.59	Professional		$108.31	$108.31	$111.59
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $394.02 / $2,085.61 / $5,017.60	Facility		$394.02	$2,085.61	$5,017.60
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $54.67 / $778.83 / $1,509.92	Facility	52	$54.67	$778.83	$1,509.92
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $21.87 / $21.87 / $64.55	Facility	53	$21.87	$21.87	$64.55
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $98.28 / $224.57 / $555.37	Professional		$98.28	$224.57	$555.37
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,190.07 / $1,470.41 / $1,903.45	Facility		$1,190.07	$1,470.41	$1,903.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $112.22 / $405.90 / $810.50	Professional		$112.22	$405.90	$810.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $179.49 / $714.12 / $1,404.00	Facility		$179.49	$714.12	$1,404.00
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $143.59 / $143.59 / $143.59	Facility	52	$143.59	$143.59	$143.59
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $35.90 / $35.90 / $35.90	Facility	53	$35.90	$35.90	$35.90
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $115.75 / $242.69 / $510.06	Professional		$115.75	$242.69	$510.06
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $98.03 / $103.01 / $284.18	Facility		$98.03	$103.01	$284.18
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $100.05 / $269.41 / $306.88	Professional		$100.05	$269.41	$306.88
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 $264.74 / $360.33 / $582.80	Professional		$264.74	$360.33	$582.80