Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $836.43 / $2,747.00 / $7,799.00	Facility		$836.43	$2,747.00	$7,799.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $603.48 / $675.43 / $675.43	Facility	54	$603.48	$675.43	$675.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $599.08 / $804.64 / $1,335.70	Professional		$599.08	$804.64	$1,335.70
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $104.30 / $124.89 / $168.79	Professional	55	$104.30	$124.89	$168.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $749.63 / $805.97 / $826.82	Professional		$749.63	$805.97	$826.82
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,299.82 / $2,746.00 / $13,822.74	Facility		$2,299.82	$2,746.00	$13,822.74
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $794.61 / $824.59 / $1,341.76	Professional		$794.61	$824.59	$1,341.76
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 $627.40 / $800.60 / $1,309.75	Professional		$627.40	$800.60	$1,309.75
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $966.19 / $966.19 / $1,245.92	Professional		$966.19	$966.19	$1,245.92
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,772.65 / $5,705.48 / $9,822.54	Facility		$2,772.65	$5,705.48	$9,822.54
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $923.34 / $993.13 / $1,285.66	Professional		$923.34	$993.13	$1,285.66
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 $675.43 / $675.43 / $675.43	Facility	54	$675.43	$675.43	$675.43
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $636.28 / $888.30 / $1,978.00	Professional		$636.28	$888.30	$1,978.00
Martin's Point Facility/Professional Professional Modifier 55 Low / Median / High Price $105.20 / $125.89 / $329.82	Professional	55	$105.20	$125.89	$329.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $806.20 / $806.20 / $806.20	Professional		$806.20	$806.20	$806.20
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 $634.79 / $835.47 / $1,309.75	Professional		$634.79	$835.47	$1,309.75
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $742.78 / $791.38 / $791.38	Facility		$742.78	$791.38	$791.38
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $742.78 / $791.38 / $844.58	Professional		$742.78	$791.38	$844.58
United Facility/Professional Facility Modifier Low / Median / High Price $1,122.00 / $2,884.00 / $6,000.00	Facility		$1,122.00	$2,884.00	$6,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $656.06 / $837.07 / $1,490.78	Professional		$656.06	$837.07	$1,490.78