Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.91 / $1,280.32 / $5,958.00	Facility		$123.91	$1,280.32	$5,958.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $16.82 / $16.82 / $40.17	Facility	53	$16.82	$16.82	$40.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.48 / $167.37 / $278.08	Professional		$77.48	$167.37	$278.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.46 / $85.46 / $94.12	Professional		$85.46	$85.46	$94.12
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 $178.65 / $185.39 / $196.99	Professional		$178.65	$185.39	$196.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.54 / $140.54 / $140.54	Facility		$140.54	$140.54	$140.54
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.11 / $28.11 / $28.11	Facility	53	$28.11	$28.11	$28.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.43 / $168.22 / $353.93	Professional		$85.43	$168.22	$353.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $214.08 / $276.67 / $369.44	Professional		$214.08	$276.67	$369.44
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $320.25 / $962.87 / $1,184.94	Facility		$320.25	$962.87	$1,184.94
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.39 / $121.28 / $152.88	Professional		$85.39	$121.28	$152.88
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $200.85 / $1,544.00 / $6,432.00	Facility		$200.85	$1,544.00	$6,432.00
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $16.82 / $16.82 / $40.17	Facility	53	$16.82	$16.82	$40.17
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $80.18 / $184.40 / $455.82	Professional		$80.18	$184.40	$455.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.73 / $235.70 / $360.80	Professional		$76.73	$235.70	$360.80
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $88.97 / $140.54 / $140.54	Facility		$88.97	$140.54	$140.54
Priority Health Facility/Professional Facility Modifier 53 Low / Median / High Price $28.11 / $28.11 / $28.11	Facility	53	$28.11	$28.11	$28.11
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $87.28 / $168.22 / $346.09	Professional		$87.28	$168.22	$346.09
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $82.06 / $153.41 / $478.46	Facility		$82.06	$153.41	$478.46
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $82.06 / $181.54 / $198.55	Professional		$82.06	$181.54	$198.55
United Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $1,078.00 / $3,742.00	Facility		$144.00	$1,078.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $195.05 / $253.57 / $385.39	Professional		$195.05	$253.57	$385.39