Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.85 / $2,759.71 / $7,697.20	Facility		$89.85	$2,759.71	$7,697.20
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $586.80 / $586.80 / $586.80	Facility	50	$586.80	$586.80	$586.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.42 / $89.57 / $188.55	Professional		$50.42	$89.57	$188.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $127.71 / $134.30 / $199.97	Professional	50	$127.71	$134.30	$199.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.13 / $60.13 / $60.13	Professional		$60.13	$60.13	$60.13
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $17,801.38 / $17,801.38 / $17,801.38	Facility		$17,801.38	$17,801.38	$17,801.38
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 $113.95 / $140.03 / $219.14	Professional		$113.95	$140.03	$219.14
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $170.92 / $210.04 / $328.75	Professional	50	$170.92	$210.04	$328.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.26 / $109.26 / $109.26	Facility		$109.26	$109.26	$109.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.60 / $102.29 / $190.92	Professional		$63.60	$102.29	$190.92
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $134.84 / $179.03 / $232.90	Professional		$134.84	$179.03	$232.90
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $226.55 / $809.47 / $2,902.47	Facility		$226.55	$809.47	$2,902.47
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $209.36 / $209.36 / $2,705.64	Facility	50	$209.36	$209.36	$2,705.64
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $145.84 / $145.84 / $145.84	Professional		$145.84	$145.84	$145.84
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $17,801.38 / $17,801.38 / $22,552.91	Facility		$17,801.38	$17,801.38	$22,552.91
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $67.79 / $67.79 / $67.79	Professional		$67.79	$67.79	$67.79
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $81.48 / $2,042.19 / $7,197.00	Facility		$81.48	$2,042.19	$7,197.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $586.80 / $586.80 / $586.80	Facility	50	$586.80	$586.80	$586.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $51.85 / $99.21 / $221.03	Professional		$51.85	$99.21	$221.03
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $127.71 / $134.30 / $199.97	Professional	50	$127.71	$134.30	$199.97
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $13,762.73 / $20,275.84 / $25,434.61	Facility		$13,762.73	$20,275.84	$25,434.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.13 / $94.69 / $219.40	Professional		$60.13	$94.69	$219.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $109.26 / $109.26 / $109.26	Facility		$109.26	$109.26	$109.26
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $63.60 / $105.15 / $194.91	Professional		$63.60	$105.15	$194.91
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $61.75 / $88.06 / $129.77	Facility		$61.75	$88.06	$129.77
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $61.75 / $110.89 / $120.37	Professional		$61.75	$110.89	$120.37
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 $77.61 / $110.16 / $180.15	Professional		$77.61	$110.16	$180.15