Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.51 / $1,234.00 / $2,867.50	Facility		$92.51	$1,234.00	$2,867.50
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $623.70 / $1,331.08 / $3,321.88	Facility	50	$623.70	$1,331.08	$3,321.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.19 / $84.51 / $249.88	Professional		$47.19	$84.51	$249.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $71.89 / $150.57 / $408.83	Professional	50	$71.89	$150.57	$408.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.02 / $78.02 / $83.91	Professional		$78.02	$78.02	$83.91
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $6,722.73 / $6,722.73 / $6,722.73	Facility		$6,722.73	$6,722.73	$6,722.73
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 $88.94 / $133.97 / $173.24	Professional		$88.94	$133.97	$173.24
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $133.41 / $200.94 / $259.83	Professional	50	$133.41	$200.94	$259.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.87 / $86.87 / $86.87	Facility		$86.87	$86.87	$86.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.17 / $89.79 / $156.58	Professional		$55.17	$89.79	$156.58
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $105.49 / $140.15 / $182.21	Professional		$105.49	$140.15	$182.21
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $182.38 / $437.84 / $1,836.76	Facility		$182.38	$437.84	$1,836.76
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $230.83 / $908.27 / $3,673.51	Facility	50	$230.83	$908.27	$3,673.51
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.69 / $84.96 / $94.14	Professional		$47.69	$84.96	$94.14
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $71.20 / $128.38 / $140.54	Professional	50	$71.20	$128.38	$140.54
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $6,722.73 / $6,722.73 / $8,517.16	Facility		$6,722.73	$6,722.73	$8,517.16
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $81.91 / $1,157.52 / $3,964.00	Facility		$81.91	$1,157.52	$3,964.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $437.04 / $1,390.76 / $3,374.74	Facility	50	$437.04	$1,390.76	$3,374.74
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $48.85 / $88.90 / $249.88	Professional		$48.85	$88.90	$249.88
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $71.89 / $148.52 / $389.95	Professional	50	$71.89	$148.52	$389.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.30 / $95.30 / $189.40	Professional		$95.30	$95.30	$189.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $86.87 / $86.87 / $86.87	Facility		$86.87	$86.87	$86.87
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $55.17 / $90.04 / $160.55	Professional		$55.17	$90.04	$160.55
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $49.92 / $58.02 / $89.50	Facility		$49.92	$58.02	$89.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $49.92 / $85.87 / $93.41	Professional		$49.92	$85.87	$93.41
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 $83.64 / $119.04 / $173.55	Professional		$83.64	$119.04	$173.55