Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $228.52 / $1,301.00 / $6,012.00	Facility		$228.52	$1,301.00	$6,012.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $190.37 / $190.37 / $244.88	Facility	54	$190.37	$190.37	$244.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $227.86 / $290.91 / $735.34	Professional		$227.86	$290.91	$735.34
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $341.79 / $508.50 / $2,704.50	Professional	50	$341.79	$508.50	$2,704.50
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $169.67 / $218.18 / $305.33	Professional	54	$169.67	$218.18	$305.33
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $33.93 / $43.64 / $61.07	Professional	55	$33.93	$43.64	$61.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $216.67 / $298.18 / $393.30	Professional		$216.67	$298.18	$393.30
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $449.48 / $449.48 / $449.48	Professional	50	$449.48	$449.48	$449.48
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $276.33 / $332.22 / $602.03	Professional		$276.33	$332.22	$602.03
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $990.00 / $2,594.00 / $5,296.01	Facility		$990.00	$2,594.00	$5,296.01
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $287.51 / $436.30 / $710.41	Professional		$287.51	$436.30	$710.41
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $431.27 / $654.45 / $1,065.64	Professional	50	$431.27	$654.45	$1,065.64
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 $217.79 / $334.41 / $529.07	Professional		$217.79	$334.41	$529.07
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $350.87 / $350.87 / $452.45	Professional		$350.87	$350.87	$452.45
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $983.00 / $2,435.31 / $2,872.73	Facility		$983.00	$2,435.31	$2,872.73
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $3,688.47 / $3,688.47 / $3,688.47	Facility	50	$3,688.47	$3,688.47	$3,688.47
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $284.50 / $351.53 / $433.58	Professional		$284.50	$351.53	$433.58
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $426.75 / $542.10 / $582.24	Professional	50	$426.75	$542.10	$582.24
Highmark BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $239.16 / $239.16 / $252.98	Professional	54	$239.16	$239.16	$252.98
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $276.33 / $332.22 / $602.03	Professional		$276.33	$332.22	$602.03
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $480.68 / $1,819.00 / $7,197.00	Facility		$480.68	$1,819.00	$7,197.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $190.37 / $190.37 / $244.88	Facility	54	$190.37	$190.37	$244.88
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $228.52 / $299.83 / $961.21	Professional		$228.52	$299.83	$961.21
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $341.79 / $508.50 / $2,704.50	Professional	50	$341.79	$508.50	$2,704.50
Martin's Point Facility/Professional Professional Modifier 54 Low / Median / High Price $170.81 / $218.18 / $462.88	Professional	54	$170.81	$218.18	$462.88
Martin's Point Facility/Professional Professional Modifier 55 Low / Median / High Price $34.15 / $43.64 / $92.58	Professional	55	$34.15	$43.64	$92.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $301.07 / $420.00 / $627.80	Professional		$301.07	$420.00	$627.80
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 $212.42 / $315.05 / $529.07	Professional		$212.42	$315.05	$529.07
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $226.34 / $287.04 / $376.87	Facility		$226.34	$287.04	$376.87
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $224.91 / $286.63 / $344.30	Professional		$224.91	$286.63	$344.30
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 $284.14 / $365.24 / $575.05	Professional		$284.14	$365.24	$575.05