Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $480.68 / $1,013.00 / $6,012.00	Facility		$480.68	$1,013.00	$6,012.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $183.13 / $556.58 / $1,528.56	Facility	50	$183.13	$556.58	$1,528.56
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $164.54 / $175.50 / $199.74	Facility	54	$164.54	$175.50	$199.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.27 / $288.55 / $630.91	Professional		$204.27	$288.55	$630.91
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $416.31 / $587.26 / $1,178.32	Professional	50	$416.31	$587.26	$1,178.32
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $149.21 / $193.60 / $295.58	Professional	54	$149.21	$193.60	$295.58
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $29.54 / $36.99 / $50.92	Professional	55	$29.54	$36.99	$50.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $189.68 / $225.06 / $294.88	Professional		$189.68	$225.06	$294.88
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $223.44 / $270.67 / $640.15	Professional		$223.44	$270.67	$640.15
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $680.00 / $2,594.00 / $5,296.01	Facility		$680.00	$2,594.00	$5,296.01
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $238.56 / $247.57 / $440.31	Professional		$238.56	$247.57	$440.31
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $357.85 / $371.35 / $660.47	Professional	50	$357.85	$371.35	$660.47
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 $189.68 / $282.20 / $453.45	Professional		$189.68	$282.20	$453.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $288.10 / $288.10 / $371.51	Professional		$288.10	$288.10	$371.51
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $836.77 / $1,069.51 / $2,499.98	Facility		$836.77	$1,069.51	$2,499.98
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $232.99 / $295.83 / $413.66	Professional		$232.99	$295.83	$413.66
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $374.81 / $443.76 / $666.05	Professional	50	$374.81	$443.76	$666.05
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $223.44 / $270.67 / $640.15	Professional		$223.44	$270.67	$640.15
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $556.02 / $2,381.00 / $7,799.00	Facility		$556.02	$2,381.00	$7,799.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $183.13 / $556.58 / $1,528.56	Facility	50	$183.13	$556.58	$1,528.56
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $164.54 / $175.50 / $213.06	Facility	54	$164.54	$175.50	$213.06
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $204.71 / $295.63 / $790.97	Professional		$204.71	$295.63	$790.97
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $416.31 / $876.78 / $1,178.32	Professional	50	$416.31	$876.78	$1,178.32
Martin's Point Facility/Professional Professional Modifier 54 Low / Median / High Price $154.09 / $199.74 / $398.47	Professional	54	$154.09	$199.74	$398.47
Martin's Point Facility/Professional Professional Modifier 55 Low / Median / High Price $29.84 / $38.72 / $79.69	Professional	55	$29.84	$38.72	$79.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $265.86 / $446.60 / $488.34	Professional		$265.86	$446.60	$488.34
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 $184.62 / $278.66 / $466.12	Professional		$184.62	$278.66	$466.12
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $197.57 / $236.14 / $447.05	Facility		$197.57	$236.14	$447.05
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $196.79 / $234.49 / $447.05	Professional		$196.79	$234.49	$447.05
United Facility/Professional Facility Modifier Low / Median / High Price $412.00 / $1,219.00 / $4,300.00	Facility		$412.00	$1,219.00	$4,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $231.22 / $301.24 / $487.15	Professional		$231.22	$301.24	$487.15