Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $271.50 / $1,425.51 / $5,350.00	Facility		$271.50	$1,425.51	$5,350.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $42.81 / $135.75 / $942.84	Facility	52	$42.81	$135.75	$942.84
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $17.12 / $17.12 / $54.30	Facility	53	$17.12	$17.12	$54.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.92 / $232.90 / $501.83	Professional		$77.92	$232.90	$501.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $35.67 / $87.38 / $137.05	Professional	52	$35.67	$87.38	$137.05
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $14.27 / $34.95 / $54.82	Professional	53	$14.27	$34.95	$54.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $364.20 / $364.20 / $396.27	Professional		$364.20	$364.20	$396.27
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $17,230.37 / $17,230.37 / $17,230.37	Facility		$17,230.37	$17,230.37	$17,230.37
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $297.33 / $297.33 / $297.33	Professional		$297.33	$297.33	$297.33
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,052.00 / $2,838.15 / $6,846.16	Facility		$1,052.00	$2,838.15	$6,846.16
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $213.27 / $221.32 / $448.29	Professional		$213.27	$221.32	$448.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.83 / $219.21 / $407.83	Professional		$96.83	$219.21	$407.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $20.39 / $224.16 / $342.90	Professional		$20.39	$224.16	$342.90
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $872.90 / $1,625.65 / $3,039.54	Facility		$872.90	$1,625.65	$3,039.54
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $17,230.37 / $17,230.37 / $21,829.50	Facility		$17,230.37	$17,230.37	$21,829.50
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $223.75 / $297.33 / $333.02	Professional		$223.75	$297.33	$333.02
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $254.26 / $1,777.97 / $6,401.86	Facility		$254.26	$1,777.97	$6,401.86
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $42.81 / $135.75 / $942.84	Facility	52	$42.81	$135.75	$942.84
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $17.12 / $17.12 / $54.30	Facility	53	$17.12	$17.12	$54.30
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $77.92 / $233.40 / $513.13	Professional		$77.92	$233.40	$513.13
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $38.18 / $95.64 / $211.48	Professional	52	$38.18	$95.64	$211.48
Martin's Point Facility/Professional Professional Modifier 53 Low / Median / High Price $15.27 / $38.25 / $84.59	Professional	53	$15.27	$38.25	$84.59
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,419.93 / $1,419.93 / $1,419.93	Facility		$1,419.93	$1,419.93	$1,419.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $217.30 / $251.90 / $661.00	Professional		$217.30	$251.90	$661.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $96.83 / $219.98 / $408.85	Professional		$96.83	$219.98	$408.85
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $77.92 / $211.28 / $328.23	Facility		$77.92	$211.28	$328.23
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $77.92 / $228.03 / $250.06	Professional		$77.92	$228.03	$250.06
United Facility/Professional Facility Modifier Low / Median / High Price $471.00 / $1,305.00 / $3,742.00	Facility		$471.00	$1,305.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $205.28 / $247.43 / $412.69	Professional		$205.28	$247.43	$412.69