Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.74 / $1,892.99 / $5,420.00	Facility		$102.74	$1,892.99	$5,420.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,578.00 / $2,578.00 / $2,578.00	Facility	50	$2,578.00	$2,578.00	$2,578.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.13 / $118.62 / $256.95	Professional		$53.13	$118.62	$256.95
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $342.67 / $382.73 / $768.00	Professional	50	$342.67	$382.73	$768.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.08 / $136.08 / $136.08	Professional		$136.08	$136.08	$136.08
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,299.82 / $2,746.00 / $13,822.74	Facility		$2,299.82	$2,746.00	$13,822.74
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $152.22 / $168.94 / $255.19	Professional		$152.22	$168.94	$255.19
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $228.32 / $288.11 / $382.83	Professional	50	$228.32	$288.11	$382.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.26 / $123.26 / $123.26	Facility		$123.26	$123.26	$123.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $139.18 / $247.79	Professional		$70.00	$139.18	$247.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $182.13 / $242.73 / $314.58	Professional		$182.13	$242.73	$314.58
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $314.69 / $1,693.55 / $3,886.07	Facility		$314.69	$1,693.55	$3,886.07
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.78 / $160.78 / $160.78	Professional		$160.78	$160.78	$160.78
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $261.92 / $261.92 / $261.92	Professional	50	$261.92	$261.92	$261.92
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $154.69 / $154.69 / $154.69	Professional		$154.69	$154.69	$154.69
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $102.74 / $1,738.77 / $5,750.00	Facility		$102.74	$1,738.77	$5,750.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $2,578.00 / $2,578.00 / $2,578.00	Facility	50	$2,578.00	$2,578.00	$2,578.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $64.76 / $128.60 / $318.47	Professional		$64.76	$128.60	$318.47
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $342.67 / $382.73 / $768.00	Professional	50	$342.67	$382.73	$768.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $68.04 / $191.60 / $270.25	Professional		$68.04	$191.60	$270.25
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $123.26 / $123.26 / $123.26	Facility		$123.26	$123.26	$123.26
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $69.41 / $139.46 / $253.78	Professional		$69.41	$139.46	$253.78
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $71.61 / $99.35 / $155.38	Facility		$71.61	$99.35	$155.38
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $71.61 / $152.72 / $166.96	Professional		$71.61	$152.72	$166.96
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 $123.07 / $173.53 / $242.66	Professional		$123.07	$173.53	$242.66