Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $752.66 / $878.99 / $976.34	Facility		$752.66	$878.99	$976.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $582.40 / $1,027.89 / $2,235.40	Professional		$582.40	$1,027.89	$2,235.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,465.40 / $1,570.00 / $1,892.92	Professional		$1,465.40	$1,570.00	$1,892.92
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $1,072.54 / $1,072.54 / $1,226.99	Professional		$1,072.54	$1,072.54	$1,226.99
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 $1,022.42 / $1,336.62 / $1,645.57	Professional		$1,022.42	$1,336.62	$1,645.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $756.84 / $1,051.31 / $1,639.56	Professional		$756.84	$1,051.31	$1,639.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,670.96	Professional		$1,000.00	$1,000.00	$1,670.96
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,072.54 / $1,072.54 / $1,226.99	Professional		$1,072.54	$1,072.54	$1,226.99
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $752.66 / $784.65 / $976.34	Facility		$752.66	$784.65	$976.34
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $653.55 / $1,298.13 / $2,089.36	Professional		$653.55	$1,298.13	$2,089.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,095.00 / $2,599.50	Professional		$1,000.00	$1,095.00	$2,599.50
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $756.84 / $1,068.23 / $1,741.90	Professional		$756.84	$1,068.23	$1,741.90
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $611.58 / $782.67 / $1,004.62	Facility		$611.58	$782.67	$1,004.62
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $745.67 / $897.00 / $1,065.58	Professional		$745.67	$897.00	$1,065.58
United Facility/Professional Facility Modifier Low / Median / High Price $625.00 / $2,391.00 / $6,322.00	Facility		$625.00	$2,391.00	$6,322.00
United Facility/Professional Professional Modifier Low / Median / High Price $715.07 / $1,018.84 / $1,718.20	Professional		$715.07	$1,018.84	$1,718.20