Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,633.00 / $5,589.85 / $9,551.66	Facility		$1,633.00	$5,589.85	$9,551.66
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $101.99 / $636.27 / $2,625.80	Facility	52	$101.99	$636.27	$2,625.80
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $40.79 / $40.79 / $254.51	Facility	53	$40.79	$40.79	$254.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.00 / $368.93 / $1,416.78	Professional		$206.00	$368.93	$1,416.78
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $40.69 / $73.79 / $283.33	Professional	53	$40.69	$73.79	$283.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $203.82 / $388.28 / $2,240.84	Professional		$203.82	$388.28	$2,240.84
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,856.23 / $3,594.05 / $16,247.43	Facility		$2,856.23	$3,594.05	$16,247.43
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $239.97 / $239.97 / $1,772.32	Professional		$239.97	$239.97	$1,772.32
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,450.00 / $6,066.00 / $8,811.00	Facility		$2,450.00	$6,066.00	$8,811.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,196.58 / $1,241.73 / $1,241.73	Professional		$1,196.58	$1,241.73	$1,241.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.64 / $432.95 / $2,029.34	Professional		$257.64	$432.95	$2,029.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,475.45 / $1,958.87 / $2,025.68	Professional		$1,475.45	$1,958.87	$2,025.68
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,843.79 / $6,730.93 / $11,938.27	Facility		$2,843.79	$6,730.93	$11,938.27
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,837.97 / $3,638.44 / $8,870.81	Facility		$2,837.97	$3,638.44	$8,870.81
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $239.97 / $239.97 / $1,772.32	Professional		$239.97	$239.97	$1,772.32
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,224.00 / $5,845.79 / $9,642.83	Facility		$1,224.00	$5,845.79	$9,642.83
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $101.99 / $874.50 / $6,042.09	Facility	52	$101.99	$874.50	$6,042.09
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $40.79 / $40.79 / $254.51	Facility	53	$40.79	$40.79	$254.51
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $222.46 / $411.02 / $1,986.42	Professional		$222.46	$411.02	$1,986.42
Martin's Point Facility/Professional Professional Modifier 53 Low / Median / High Price $41.09 / $82.20 / $473.38	Professional	53	$41.09	$82.20	$473.38
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $4,992.43 / $5,248.49 / $6,605.62	Facility		$4,992.43	$5,248.49	$6,605.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $381.80 / $3,819.70	Professional		$4.00	$381.80	$3,819.70
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $263.95 / $453.23 / $2,029.34	Professional		$263.95	$453.23	$2,029.34
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $226.68 / $259.75 / $1,440.27	Facility		$226.68	$259.75	$1,440.27
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $226.68 / $1,267.61 / $1,407.11	Professional		$226.68	$1,267.61	$1,407.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,334.00 / $2,824.00 / $5,678.00	Facility		$1,334.00	$2,824.00	$5,678.00
United Facility/Professional Professional Modifier Low / Median / High Price $337.72 / $1,551.88 / $2,672.43	Professional		$337.72	$1,551.88	$2,672.43