Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,569.00 / $3,839.00 / $9,534.00	Facility		$1,569.00	$3,839.00	$9,534.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,073.52 / $5,073.52 / $5,073.52	Facility	50	$5,073.52	$5,073.52	$5,073.52
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $540.66 / $598.04 / $598.04	Facility	54	$540.66	$598.04	$598.04
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $108.13 / $119.61 / $119.61	Facility	55	$108.13	$119.61	$119.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $713.67 / $912.60 / $2,489.79	Professional		$713.67	$912.60	$2,489.79
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $535.25 / $598.04 / $902.64	Professional	54	$535.25	$598.04	$902.64
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $107.05 / $116.49 / $167.20	Professional	55	$107.05	$116.49	$167.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $526.79 / $745.96 / $1,117.46	Professional		$526.79	$745.96	$1,117.46
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $4,092.00 / $7,463.00 / $11,048.00	Facility		$4,092.00	$7,463.00	$11,048.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $727.72 / $1,118.86 / $2,001.01	Professional		$727.72	$1,118.86	$2,001.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,051.00 / $1,051.00 / $1,051.00	Facility		$1,051.00	$1,051.00	$1,051.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $583.54 / $915.30 / $1,457.40	Professional		$583.54	$915.30	$1,457.40
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $528.00 / $872.39 / $1,124.97	Professional		$528.00	$872.39	$1,124.97
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,702.45 / $4,306.60 / $10,227.60	Facility		$1,702.45	$4,306.60	$10,227.60
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $33,234.04 / $33,234.04 / $33,234.04	Facility	50	$33,234.04	$33,234.04	$33,234.04
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $845.88 / $1,144.46 / $1,501.82	Professional		$845.88	$1,144.46	$1,501.82
Highmark BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $592.12 / $626.36 / $634.45	Professional	54	$592.12	$626.36	$634.45
Highmark BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $167.88 / $178.96 / $224.09	Professional	55	$167.88	$178.96	$224.09
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,301.00 / $5,342.00 / $10,247.00	Facility		$1,301.00	$5,342.00	$10,247.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $5,073.52 / $5,073.52 / $5,073.52	Facility	50	$5,073.52	$5,073.52	$5,073.52
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $598.04 / $598.04 / $598.04	Facility	54	$598.04	$598.04	$598.04
Martin's Point Facility/Professional Facility Modifier 55 Low / Median / High Price $119.61 / $119.61 / $119.61	Facility	55	$119.61	$119.61	$119.61
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $720.87 / $937.14 / $2,588.39	Professional		$720.87	$937.14	$2,588.39
Martin's Point Facility/Professional Professional Modifier 54 Low / Median / High Price $535.25 / $663.84 / $1,068.38	Professional	54	$535.25	$663.84	$1,068.38
Martin's Point Facility/Professional Professional Modifier 55 Low / Median / High Price $107.05 / $119.61 / $290.23	Professional	55	$107.05	$119.61	$290.23
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $898.32 / $1,024.70 / $1,507.54	Professional		$898.32	$1,024.70	$1,507.54
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,051.00 / $1,051.00 / $1,051.00	Facility		$1,051.00	$1,051.00	$1,051.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $601.19 / $895.15 / $1,460.71	Professional		$601.19	$895.15	$1,460.71
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $714.66 / $714.66 / $1,145.54	Facility		$714.66	$714.66	$1,145.54
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $699.88 / $714.66 / $1,145.54	Professional		$699.88	$714.66	$1,145.54
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 $719.25 / $889.00 / $1,428.42	Professional		$719.25	$889.00	$1,428.42