Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $653.26 / $3,587.84 / $7,133.18	Facility		$653.26	$3,587.84	$7,133.18
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,190.51 / $3,998.40 / $9,232.50	Facility	50	$2,190.51	$3,998.40	$9,232.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $374.27 / $445.72 / $1,350.51	Professional		$374.27	$445.72	$1,350.51
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $206.57 / $1,316.76 / $1,430.82	Professional	50	$206.57	$1,316.76	$1,430.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $362.67 / $665.25 / $757.00	Professional		$362.67	$665.25	$757.00
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $2,181.46 / $3,574.87 / $22,243.24	Facility		$2,181.46	$3,574.87	$22,243.24
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $3,292.00 / $6,066.00 / $8,887.00	Facility		$3,292.00	$6,066.00	$8,887.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $448.45 / $672.61 / $850.07	Professional		$448.45	$672.61	$850.07
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $672.68 / $1,016.16 / $1,275.06	Professional	50	$672.68	$1,016.16	$1,275.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $742.64 / $742.64 / $742.64	Facility		$742.64	$742.64	$742.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $391.61 / $526.74 / $839.79	Professional		$391.61	$526.74	$839.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $535.04 / $722.52 / $924.18	Professional		$535.04	$722.52	$924.18
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,939.22 / $4,064.35 / $8,103.57	Facility		$1,939.22	$4,064.35	$8,103.57
Highmark BCBS Facility/Professional Facility Modifier 22 Low / Median / High Price $2,584.62 / $2,584.62 / $2,584.62	Facility	22	$2,584.62	$2,584.62	$2,584.62
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,088.25 / $5,203.81 / $7,663.19	Facility	50	$2,088.25	$5,203.81	$7,663.19
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $441.39 / $524.09 / $594.15	Professional		$441.39	$524.09	$594.15
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $700.14 / $740.63 / $1,243.07	Professional	50	$700.14	$740.63	$1,243.07
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,048.14 / $3,489.33 / $8,570.84	Facility		$2,048.14	$3,489.33	$8,570.84
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $552.95 / $3,564.60 / $7,901.10	Facility		$552.95	$3,564.60	$7,901.10
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $2,049.15 / $3,998.40 / $9,232.50	Facility	50	$2,049.15	$3,998.40	$9,232.50
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $377.02 / $509.50 / $1,350.51	Professional		$377.02	$509.50	$1,350.51
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $619.71 / $1,316.76 / $7,654.62	Professional	50	$619.71	$1,316.76	$7,654.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $471.90 / $499.20 / $899.00	Professional		$471.90	$499.20	$899.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $742.64 / $742.64 / $742.64	Facility		$742.64	$742.64	$742.64
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $392.80 / $546.76 / $866.13	Professional		$392.80	$546.76	$866.13
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $399.82 / $427.74 / $435.33	Facility		$399.82	$427.74	$435.33
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $405.78 / $427.74 / $464.88	Professional		$405.78	$427.74	$464.88
United Facility/Professional Facility Modifier Low / Median / High Price $1,334.00 / $3,198.00 / $13,418.00	Facility		$1,334.00	$3,198.00	$13,418.00
United Facility/Professional Professional Modifier Low / Median / High Price $420.07 / $545.19 / $861.12	Professional		$420.07	$545.19	$861.12