Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $1,995.26 / $4,786.30	Facility		$478.63	$1,995.26	$4,786.30
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,630.78 / $3,630.78 / $3,630.78	Facility	22	$3,630.78	$3,630.78	$3,630.78
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,513.56 / $3,019.95 / $6,165.95	Facility	50	$1,513.56	$3,019.95	$6,165.95
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility	53	$1,174.90	$1,174.90	$1,174.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $239.88 / $741.31	Professional		$104.71	$239.88	$741.31
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.25 / $478.63 / $1,548.82	Professional	22	$141.25	$478.63	$1,548.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $151.36 / $363.08 / $1,348.96	Professional	50	$151.36	$363.08	$1,348.96
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $50.12 / $63.10 / $186.21	Professional	53	$50.12	$63.10	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $186.21 / $363.08	Professional		$104.71	$186.21	$363.08
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $275.42 / $380.19	Professional	50	$158.49	$275.42	$380.19
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $2,344.23 / $57,543.99	Facility		$1,995.26	$2,344.23	$57,543.99
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $331.13 / $416.87	Professional		$234.42	$331.13	$416.87
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $354.81 / $501.19 / $616.60	Professional	50	$354.81	$501.19	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Facility		$186.21	$186.21	$186.21
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	22	$223.87	$223.87	$223.87
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.02 / $38.02 / $38.02	Facility	53	$38.02	$38.02	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $213.80 / $457.09	Professional		$104.71	$213.80	$457.09
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $120.23 / $120.23 / $120.23	Professional	53	$120.23	$120.23	$120.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $436.52 / $549.54	Professional		$316.23	$436.52	$549.54
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $346.74 / $549.54	Professional		$147.91	$346.74	$549.54
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,174.90 / $2,137.96 / $3,630.78	Facility		$1,174.90	$2,137.96	$3,630.78
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,318.26 / $3,235.94 / $5,370.32	Facility	50	$1,318.26	$3,235.94	$5,370.32
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $234.42 / $245.47	Professional		$112.20	$234.42	$245.47
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $165.96 / $173.78 / $371.54	Professional	50	$165.96	$173.78	$371.54
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $1,819.70 / $4,168.69	Facility		$371.54	$1,819.70	$4,168.69
Martin's Point Facility/Professional Facility Modifier 22 Low / Median / High Price $3,630.78 / $3,630.78 / $3,630.78	Facility	22	$3,630.78	$3,630.78	$3,630.78
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $1,380.38 / $2,951.21 / $5,888.44	Facility	50	$1,380.38	$2,951.21	$5,888.44
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $1,174.90 / $1,174.90 / $1,174.90	Facility	53	$1,174.90	$1,174.90	$1,174.90
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $245.47 / $660.69	Professional		$107.15	$245.47	$660.69
Martin's Point Facility/Professional Professional Modifier 22 Low / Median / High Price $141.25 / $190.55 / $1,548.82	Professional	22	$141.25	$190.55	$1,548.82
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $151.36 / $363.08 / $1,412.54	Professional	50	$151.36	$363.08	$1,412.54
Martin's Point Facility/Professional Professional Modifier 53 Low / Median / High Price $50.12 / $97.72 / $186.21	Professional	53	$50.12	$97.72	$186.21
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $741.31 / $5,754.40	Facility		$281.84	$741.31	$5,754.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $346.74 / $524.81	Professional		$269.15	$346.74	$524.81
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $8.71 / $223.87 / $363.08	Facility		$8.71	$223.87	$363.08
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $114.82 / $323.59	Professional		$42.66	$114.82	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $1,778.28 / $3,890.45	Facility		$467.74	$1,778.28	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $208.93 / $407.38	Professional		$107.15	$208.93	$407.38