Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $461.04 / $2,115.88 / $4,765.22	Facility		$461.04	$2,115.88	$4,765.22
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,238.00 / $3,806.27 / $6,324.25	Facility	50	$2,238.00	$3,806.27	$6,324.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $184.23 / $383.87 / $758.40	Professional		$184.23	$383.87	$758.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $277.89 / $625.25 / $2,732.00	Professional	50	$277.89	$625.25	$2,732.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $294.35 / $294.35 / $294.35	Professional		$294.35	$294.35	$294.35
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $441.53 / $441.53 / $596.44	Professional	50	$441.53	$441.53	$596.44
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,253.94 / $1,717.35 / $19,837.00	Facility		$1,253.94	$1,717.35	$19,837.00
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $3,736.00 / $4,444.00 / $15,949.31	Facility		$3,736.00	$4,444.00	$15,949.31
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $421.49 / $637.86 / $851.52	Professional		$421.49	$637.86	$851.52
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $632.23 / $957.21 / $1,277.33	Professional	50	$632.23	$957.21	$1,277.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $326.10 / $326.10 / $326.10	Facility		$326.10	$326.10	$326.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $217.00 / $397.91 / $747.70	Professional		$217.00	$397.91	$747.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $118.59 / $672.64 / $874.30	Professional		$118.59	$672.64	$874.30
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,747.03 / $3,943.80 / $6,998.75	Facility		$1,747.03	$3,943.80	$6,998.75
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,705.15 / $5,083.60 / $8,648.53	Facility	50	$2,705.15	$5,083.60	$8,648.53
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $180.22 / $290.20 / $443.02	Professional		$180.22	$290.20	$443.02
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $279.25 / $291.89 / $664.53	Professional	50	$279.25	$291.89	$664.53
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,153.61 / $1,749.15 / $8,588.99	Facility		$1,153.61	$1,749.15	$8,588.99
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $403.06 / $2,447.12 / $5,587.13	Facility		$403.06	$2,447.12	$5,587.13
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $1,602.96 / $5,135.00 / $6,763.75	Facility	50	$1,602.96	$5,135.00	$6,763.75
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $190.56 / $403.06 / $978.16	Professional		$190.56	$403.06	$978.16
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $271.26 / $612.71 / $2,688.53	Professional	50	$271.26	$612.71	$2,688.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $583.40 / $1,204.40	Professional		$4.00	$583.40	$1,204.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $326.10 / $326.10 / $326.10	Facility		$326.10	$326.10	$326.10
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $217.00 / $409.96 / $764.39	Professional		$217.00	$409.96	$764.39
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $208.49 / $425.24	Facility		$186.21	$208.49	$425.24
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $389.99 / $458.23	Professional		$186.21	$389.99	$458.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,747.00 / $2,824.00 / $5,678.00	Facility		$1,747.00	$2,824.00	$5,678.00
United Facility/Professional Professional Modifier Low / Median / High Price $408.25 / $576.55 / $840.18	Professional		$408.25	$576.55	$840.18