Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.63 / $628.85 / $5,750.00	Facility		$93.63	$628.85	$5,750.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $28.17 / $28.17 / $46.46	Facility	52	$28.17	$28.17	$46.46
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $11.27 / $18.57 / $115.15	Facility	53	$11.27	$18.57	$115.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.37 / $125.85 / $292.52	Professional		$76.37	$125.85	$292.52
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.17 / $45.38 / $109.45	Professional	52	$28.17	$45.38	$109.45
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $11.27 / $18.57 / $52.79	Professional	53	$11.27	$18.57	$52.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.19 / $102.19 / $102.19	Professional		$102.19	$102.19	$102.19
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $151.54 / $151.54 / $151.54	Professional	53	$151.54	$151.54	$151.54
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $107.50 / $107.50 / $122.98	Professional		$107.50	$107.50	$122.98
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,083.51 / $1,395.00 / $5,044.89	Facility		$1,083.51	$1,395.00	$5,044.89
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $98.69 / $170.79 / $251.30	Professional		$98.69	$170.79	$251.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.70 / $118.19 / $208.21	Professional		$75.70	$118.19	$208.21
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $118.38 / $157.27 / $158.02	Professional		$118.38	$157.27	$158.02
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $204.00 / $578.60 / $1,288.72	Facility		$204.00	$578.60	$1,288.72
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $104.50 / $104.50 / $104.50	Facility	52	$104.50	$104.50	$104.50
Highmark BCBS Facility/Professional Facility Modifier 53 Low / Median / High Price $520.69 / $529.00 / $569.85	Facility	53	$520.69	$529.00	$569.85
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $107.50 / $107.50 / $218.76	Professional		$107.50	$107.50	$218.76
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $105.98 / $1,216.00 / $6,432.00	Facility		$105.98	$1,216.00	$6,432.00
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $28.17 / $28.17 / $46.46	Facility	52	$28.17	$28.17	$46.46
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $11.27 / $18.57 / $115.15	Facility	53	$11.27	$18.57	$115.15
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $77.73 / $135.97 / $275.94	Professional		$77.73	$135.97	$275.94
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $28.17 / $48.60 / $136.27	Professional	52	$28.17	$48.60	$136.27
Martin's Point Facility/Professional Professional Modifier 53 Low / Median / High Price $12.03 / $24.79 / $54.51	Professional	53	$12.03	$24.79	$54.51
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $98.70 / $268.70	Professional		$3.00	$98.70	$268.70
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $76.84 / $118.93 / $210.21	Professional		$76.84	$118.93	$210.21
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $62.01 / $99.32 / $125.93	Facility		$62.01	$99.32	$125.93
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $62.01 / $96.91 / $105.81	Professional		$62.01	$96.91	$105.81
United Facility/Professional Facility Modifier Low / Median / High Price $162.00 / $577.00 / $3,742.00	Facility		$162.00	$577.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $93.28 / $126.87 / $202.96	Professional		$93.28	$126.87	$202.96