Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $967.20 / $5,079.00 / $9,534.00	Facility		$967.20	$5,079.00	$9,534.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $655.22 / $725.40 / $725.40	Facility	54	$655.22	$725.40	$725.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $738.41 / $894.62 / $1,464.37	Professional		$738.41	$894.62	$1,464.37
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $128.44 / $135.29 / $182.71	Professional	55	$128.44	$135.29	$182.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $451.19 / $830.09 / $1,488.93	Professional		$451.19	$830.09	$1,488.93
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $6,431.95 / $7,827.00 / $19,139.18	Facility		$6,431.95	$7,827.00	$19,139.18
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $879.90 / $913.10 / $1,634.45	Professional		$879.90	$913.10	$1,634.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $892.00 / $892.00 / $892.00	Facility		$892.00	$892.00	$892.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $705.58 / $937.48 / $1,626.74	Professional		$705.58	$937.48	$1,626.74
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $300.00 / $878.75 / $1,361.09	Professional		$300.00	$878.75	$1,361.09
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,143.86 / $6,594.52 / $13,441.25	Facility		$3,143.86	$6,594.52	$13,441.25
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,024.16 / $1,083.38 / $1,356.61	Professional		$1,024.16	$1,083.38	$1,356.61
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,071.00 / $5,473.52 / $9,676.00	Facility		$1,071.00	$5,473.52	$9,676.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $725.40 / $725.40 / $725.40	Facility	54	$725.40	$725.40	$725.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $762.32 / $956.37 / $2,843.00	Professional		$762.32	$956.37	$2,843.00
Martin's Point Facility/Professional Professional Modifier 55 Low / Median / High Price $129.72 / $141.24 / $352.07	Professional	55	$129.72	$141.24	$352.07
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,011.10 / $1,011.10 / $1,011.10	Professional		$1,011.10	$1,011.10	$1,011.10
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $892.00 / $892.00 / $892.00	Facility		$892.00	$892.00	$892.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $729.43 / $953.07 / $1,639.57	Professional		$729.43	$953.07	$1,639.57
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $865.47 / $865.47 / $984.90	Facility		$865.47	$865.47	$984.90
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $847.75 / $865.47 / $984.90	Professional		$847.75	$865.47	$984.90
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 $761.31 / $991.61 / $1,645.22	Professional		$761.31	$991.61	$1,645.22