Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $183.21 / $1,234.00 / $4,407.89	Facility		$183.21	$1,234.00	$4,407.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.34 / $110.89 / $227.53	Professional		$36.34	$110.89	$227.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.60 / $40.28 / $56.11	Professional		$26.60	$40.28	$56.11
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $522.48 / $691.16 / $8,123.71	Facility		$522.48	$691.16	$8,123.71
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $167.17 / $173.48 / $260.30	Professional		$167.17	$173.48	$260.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.62 / $62.62 / $62.62	Facility		$62.62	$62.62	$62.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.34 / $85.14 / $270.27	Professional		$38.34	$85.14	$270.27
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $203.42 / $262.91 / $348.05	Professional		$203.42	$262.91	$348.05
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $263.32 / $761.60 / $1,245.32	Facility		$263.32	$761.60	$1,245.32
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.83 / $44.37 / $101.05	Professional		$37.83	$44.37	$101.05
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $439.01 / $687.48 / $5,344.98	Facility		$439.01	$687.48	$5,344.98
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $202.42 / $1,819.00 / $5,583.00	Facility		$202.42	$1,819.00	$5,583.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $37.03 / $116.87 / $333.36	Professional		$37.03	$116.87	$333.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.60 / $56.60 / $407.50	Professional		$56.60	$56.60	$407.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $41.43 / $62.62 / $62.62	Facility		$41.43	$62.62	$62.62
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $38.34 / $91.62 / $266.95	Professional		$38.34	$91.62	$266.95
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $36.43 / $104.28 / $176.18	Facility		$36.43	$104.28	$176.18
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $36.43 / $161.19 / $191.68	Professional		$36.43	$161.19	$191.68
United Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $1,078.00 / $3,742.00	Facility		$144.00	$1,078.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $129.33 / $188.34 / $327.16	Professional		$129.33	$188.34	$327.16