Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $646.48 / $2,266.00 / $8,017.00	Facility		$646.48	$2,266.00	$8,017.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $484.86 / $484.86 / $563.78	Facility	54	$484.86	$484.86	$563.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $517.96 / $671.88 / $1,164.18	Professional		$517.96	$671.88	$1,164.18
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,143.66 / $1,143.66 / $1,143.66	Professional	50	$1,143.66	$1,143.66	$1,143.66
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $431.80 / $503.91 / $677.39	Professional	54	$431.80	$503.91	$677.39
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $86.36 / $100.78 / $135.47	Professional	55	$86.36	$100.78	$135.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $305.97 / $305.97 / $305.97	Professional		$305.97	$305.97	$305.97
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 $674.13 / $699.57 / $1,216.46	Professional		$674.13	$699.57	$1,216.46
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $1,011.19 / $1,049.34 / $1,824.73	Professional	50	$1,011.19	$1,049.34	$1,824.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $358.00 / $358.00 / $358.00	Facility		$358.00	$358.00	$358.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $489.58 / $656.94 / $1,078.49	Professional		$489.58	$656.94	$1,078.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $820.50 / $820.50 / $1,058.06	Professional		$820.50	$820.50	$1,058.06
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,335.07 / $1,640.71 / $3,442.74	Facility		$1,335.07	$1,640.71	$3,442.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $682.82 / $837.73 / $887.41	Professional		$682.82	$837.73	$887.41
Highmark BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $586.41 / $586.41 / $586.41	Professional	54	$586.41	$586.41	$586.41
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $641.00 / $2,422.00 / $8,017.00	Facility		$641.00	$2,422.00	$8,017.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $484.86 / $484.86 / $563.78	Facility	54	$484.86	$484.86	$563.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $560.07 / $699.50 / $1,920.04	Professional		$560.07	$699.50	$1,920.04
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $1,143.66 / $1,143.66 / $1,143.66	Professional	50	$1,143.66	$1,143.66	$1,143.66
Martin's Point Facility/Professional Professional Modifier 54 Low / Median / High Price $434.77 / $511.93 / $1,179.56	Professional	54	$434.77	$511.93	$1,179.56
Martin's Point Facility/Professional Professional Modifier 55 Low / Median / High Price $86.95 / $102.39 / $235.91	Professional	55	$86.95	$102.39	$235.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $627.10 / $627.10 / $627.10	Professional		$627.10	$627.10	$627.10
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $358.00 / $358.00 / $358.00	Facility		$358.00	$358.00	$358.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $500.40 / $671.20 / $1,074.08	Professional		$500.40	$671.20	$1,074.08
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $479.47 / $577.70 / $665.27	Facility		$479.47	$577.70	$665.27
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $533.65 / $613.57 / $709.98	Professional		$533.65	$613.57	$709.98
United Facility/Professional Facility Modifier Low / Median / High Price $637.00 / $2,391.00 / $6,000.00	Facility		$637.00	$2,391.00	$6,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $562.17 / $741.27 / $1,191.08	Professional		$562.17	$741.27	$1,191.08