Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,337.00 / $8,286.69 / $18,815.29	Facility		$2,337.00	$8,286.69	$18,815.29
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $7,010.63 / $7,010.63 / $7,010.63	Facility	22	$7,010.63	$7,010.63	$7,010.63
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,545.27 / $9,770.69 / $21,609.69	Facility	50	$5,545.27	$9,770.69	$21,609.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $361.88 / $524.74 / $1,645.00	Professional		$361.88	$524.74	$1,645.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $469.40 / $653.52 / $802.07	Professional		$469.40	$653.52	$802.07
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $54,726.90 / $54,726.90 / $54,726.90	Facility		$54,726.90	$54,726.90	$54,726.90
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $456.90 / $495.90 / $801.04	Professional		$456.90	$495.90	$801.04
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $6,393.00 / $11,730.00 / $18,724.00	Facility		$6,393.00	$11,730.00	$18,724.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $436.00 / $626.49 / $863.99	Professional		$436.00	$626.49	$863.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $606.00 / $2,656.00 / $7,893.93	Facility		$606.00	$2,656.00	$7,893.93
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $48.91 / $48.91 / $48.91	Facility	AS	$48.91	$48.91	$48.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.57 / $528.51 / $888.78	Professional		$380.57	$528.51	$888.78
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $984.88 / $984.88 / $984.88	Facility		$984.88	$984.88	$984.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $528.17 / $684.04 / $879.15	Professional		$528.17	$684.04	$879.15
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,340.75 / $12,211.54 / $25,184.17	Facility		$4,340.75	$12,211.54	$25,184.17
Highmark BCBS Facility/Professional Facility Modifier 22 Low / Median / High Price $5,447.00 / $5,447.00 / $5,447.00	Facility	22	$5,447.00	$5,447.00	$5,447.00
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $3,638.56 / $13,168.11 / $25,627.95	Facility	50	$3,638.56	$13,168.11	$25,627.95
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $425.04 / $449.62 / $542.13	Professional		$425.04	$449.62	$542.13
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $54,726.90 / $54,726.90 / $69,334.59	Facility		$54,726.90	$54,726.90	$69,334.59
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $456.90 / $508.02 / $886.98	Professional		$456.90	$508.02	$886.98
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,536.00 / $8,240.00 / $19,885.32	Facility		$1,536.00	$8,240.00	$19,885.32
Martin's Point Facility/Professional Facility Modifier 22 Low / Median / High Price $7,010.63 / $7,010.63 / $7,010.63	Facility	22	$7,010.63	$7,010.63	$7,010.63
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $5,227.00 / $10,094.77 / $23,538.19	Facility	50	$5,227.00	$10,094.77	$23,538.19
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $361.88 / $621.09 / $1,547.48	Professional		$361.88	$621.09	$1,547.48
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $468.40 / $9,785.49 / $9,785.49	Facility		$468.40	$9,785.49	$9,785.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $450.70 / $624.97 / $925.30	Professional		$450.70	$624.97	$925.30
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $493.18 / $2,109.00 / $7,511.52	Facility		$493.18	$2,109.00	$7,511.52
Priority Health Facility/Professional Facility Modifier AS Low / Median / High Price $48.91 / $48.91 / $48.91	Facility	AS	$48.91	$48.91	$48.91
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $387.12 / $527.75 / $888.78	Professional		$387.12	$527.75	$888.78
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $424.03 / $424.03 / $502.30	Facility		$424.03	$424.03	$502.30
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $408.42 / $428.72 / $502.30	Professional		$408.42	$428.72	$502.30
United Facility/Professional Facility Modifier Low / Median / High Price $1,803.00 / $4,563.00 / $7,000.00	Facility		$1,803.00	$4,563.00	$7,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $372.65 / $488.68 / $832.95	Professional		$372.65	$488.68	$832.95