Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $617.00 / $2,505.00 / $7,197.00	Facility		$617.00	$2,505.00	$7,197.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $30.33 / $3,026.34 / $6,170.92	Facility	52	$30.33	$3,026.34	$6,170.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.05 / $60.66 / $128.80	Professional		$53.05	$60.66	$128.80
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,344.69 / $3,159.00 / $14,886.03	Facility		$2,344.69	$3,159.00	$14,886.03
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $65.15 / $67.61 / $67.61	Professional		$65.15	$67.61	$67.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.65 / $72.65 / $72.65	Facility		$72.65	$72.65	$72.65
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $56.37 / $56.37 / $56.37	Facility	52	$56.37	$56.37	$56.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.39 / $101.26 / $186.64	Professional		$62.39	$101.26	$186.64
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $74.95 / $99.95 / $129.47	Professional		$74.95	$99.95	$129.47
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $617.00 / $2,326.00 / $8,017.00	Facility		$617.00	$2,326.00	$8,017.00
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $30.33 / $3,026.34 / $6,170.92	Facility	52	$30.33	$3,026.34	$6,170.92
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $55.70 / $92.79 / $1,023.00	Professional		$55.70	$92.79	$1,023.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $59.02 / $93.50 / $142.10	Professional		$59.02	$93.50	$142.10
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $72.65 / $72.65 / $72.65	Facility		$72.65	$72.65	$72.65
Priority Health Facility/Professional Facility Modifier 52 Low / Median / High Price $56.37 / $56.37 / $56.37	Facility	52	$56.37	$56.37	$56.37
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $62.39 / $99.62 / $196.80	Professional		$62.39	$99.62	$196.80
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $60.63 / $60.63 / $152.32	Facility		$60.63	$60.63	$152.32
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $58.78 / $60.96 / $152.32	Professional		$58.78	$60.96	$152.32
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 $63.52 / $98.68 / $169.31	Professional		$63.52	$98.68	$169.31