Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $6,025.60 / $10,471.29	Facility		$1,412.54	$6,025.60	$10,471.29
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,128.61 / $5,128.61 / $5,128.61	Facility	50	$5,128.61	$5,128.61	$5,128.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $977.24 / $3,311.31	Professional		$691.83	$977.24	$3,311.31
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $316.23 / $724.44 / $1,071.52	Professional	54	$316.23	$724.44	$1,071.52
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $169.82 / $169.82 / $169.82	Professional	55	$169.82	$169.82	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $660.69 / $691.83 / $776.25	Professional		$660.69	$691.83	$776.25
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $6,456.54 / $6,606.93 / $57,543.99	Facility		$6,456.54	$6,606.93	$57,543.99
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $1,096.48 / $1,905.46	Professional		$724.44	$1,096.48	$1,905.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,047.13	Facility		$1,047.13	$1,047.13	$1,047.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $912.01 / $1,445.44	Professional		$588.84	$912.01	$1,445.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $524.81 / $831.76 / $1,047.13	Professional		$524.81	$831.76	$1,047.13
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $933.25 / $1,348.96	Professional		$630.96	$933.25	$1,348.96
Geisinger Facility/Professional Professional Modifier 55 Low / Median / High Price $691.83 / $870.96 / $1,000.00	Professional	55	$691.83	$870.96	$1,000.00
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,019.95 / $4,570.88 / $10,232.93	Facility		$3,019.95	$4,570.88	$10,232.93
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $33,113.11 / $33,113.11 / $33,113.11	Facility	50	$33,113.11	$33,113.11	$33,113.11
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $912.01 / $1,513.56	Professional		$831.76	$912.01	$1,513.56
Highmark BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $588.84 / $630.96 / $630.96	Professional	54	$588.84	$630.96	$630.96
Highmark BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $165.96 / $165.96 / $223.87	Professional	55	$165.96	$165.96	$223.87
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $5,370.32 / $10,000.00	Facility		$1,148.15	$5,370.32	$10,000.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $5,128.61 / $5,128.61 / $5,128.61	Facility	50	$5,128.61	$5,128.61	$5,128.61
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $977.24 / $2,344.23	Professional		$691.83	$977.24	$2,344.23
Martin's Point Facility/Professional Professional Modifier 54 Low / Median / High Price $316.23 / $724.44 / $1,071.52	Professional	54	$316.23	$724.44	$1,071.52
Martin's Point Facility/Professional Professional Modifier 55 Low / Median / High Price $169.82 / $169.82 / $169.82	Professional	55	$169.82	$169.82	$169.82
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $2,398.83 / $5,754.40	Facility		$1,905.46	$2,398.83	$5,754.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,023.29 / $1,023.29 / $1,318.26	Professional		$1,023.29	$1,023.29	$1,318.26
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $537.03 / $1,148.15	Facility		$537.03	$537.03	$1,148.15
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $707.95 / $1,148.15	Professional		$537.03	$707.95	$1,148.15
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $3,467.37 / $7,413.10	Facility		$1,348.96	$3,467.37	$7,413.10
United Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $851.14 / $1,445.44	Professional		$645.65	$851.14	$1,445.44