Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.93 / $988.00 / $4,888.00	Facility		$65.93	$988.00	$4,888.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,114.44 / $1,114.44 / $3,372.00	Facility	50	$1,114.44	$1,114.44	$3,372.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.73 / $48.80 / $126.96	Professional		$31.73	$48.80	$126.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $60.55 / $68.27 / $282.00	Professional	50	$60.55	$68.27	$282.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.65 / $48.94 / $68.43	Professional		$29.65	$48.94	$68.43
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $83.27 / $83.27 / $83.27	Professional	50	$83.27	$83.27	$83.27
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,083.51 / $1,395.00 / $12,759.45	Facility		$1,083.51	$1,395.00	$12,759.45
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $49.24 / $59.52 / $86.34	Professional		$49.24	$59.52	$86.34
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $73.86 / $89.66 / $129.51	Professional	50	$73.86	$89.66	$129.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.28 / $57.28 / $57.28	Facility		$57.28	$57.28	$57.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.42 / $53.38 / $88.58	Professional		$36.42	$53.38	$88.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $57.32 / $75.43 / $99.01	Professional		$57.32	$75.43	$99.01
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.38 / $655.19 / $1,311.67	Facility		$22.38	$655.19	$1,311.67
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $715.75 / $715.75 / $715.75	Facility	50	$715.75	$715.75	$715.75
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.14 / $57.61 / $71.38	Professional		$51.14	$57.61	$71.38
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $78.56 / $83.10 / $91.41	Professional	50	$78.56	$83.10	$91.41
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $54.51 / $1,403.00 / $6,432.00	Facility		$54.51	$1,403.00	$6,432.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $1,114.44 / $1,114.44 / $3,372.00	Facility	50	$1,114.44	$1,114.44	$3,372.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $32.28 / $52.03 / $124.64	Professional		$32.28	$52.03	$124.64
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $60.55 / $78.05 / $282.00	Professional	50	$60.55	$78.05	$282.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.90 / $55.60 / $96.12	Professional		$43.90	$55.60	$96.12
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $57.28 / $57.28 / $57.28	Facility		$57.28	$57.28	$57.28
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $53.41 / $92.23	Professional		$36.17	$53.41	$92.23
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $32.95 / $39.90 / $51.63	Facility		$32.95	$39.90	$51.63
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $32.95 / $47.35 / $51.09	Professional		$32.95	$47.35	$51.09
United Facility/Professional Facility Modifier Low / Median / High Price $162.00 / $650.00 / $3,742.00	Facility		$162.00	$650.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $62.46 / $92.82	Professional		$46.00	$62.46	$92.82