Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $914.78 / $5,079.00 / $9,534.00	Facility		$914.78	$5,079.00	$9,534.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $621.16 / $686.09 / $686.09	Facility	54	$621.16	$686.09	$686.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $761.10 / $903.97 / $1,356.62	Professional		$761.10	$903.97	$1,356.62
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $119.17 / $128.06 / $161.19	Professional	55	$119.17	$128.06	$161.19
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $8,639.91 / $11,851.00 / $28,970.26	Facility		$8,639.91	$11,851.00	$28,970.26
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $836.03 / $867.58 / $1,316.49	Professional		$836.03	$867.58	$1,316.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $678.00 / $678.00 / $678.00	Facility		$678.00	$678.00	$678.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $670.40 / $973.62 / $1,597.31	Professional		$670.40	$973.62	$1,597.31
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $999.78 / $999.78 / $1,289.24	Professional		$999.78	$999.78	$1,289.24
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $970.60 / $970.60 / $1,026.72	Professional		$970.60	$970.60	$1,026.72
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,298.00 / $5,350.00 / $9,830.00	Facility		$1,298.00	$5,350.00	$9,830.00
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $686.09 / $686.09 / $686.09	Facility	54	$686.09	$686.09	$686.09
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $794.44 / $969.66 / $2,020.00	Professional		$794.44	$969.66	$2,020.00
Martin's Point Facility/Professional Professional Modifier 55 Low / Median / High Price $119.17 / $128.06 / $173.12	Professional	55	$119.17	$128.06	$173.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $858.94 / $1,263.15 / $2,151.60	Professional		$858.94	$1,263.15	$2,151.60
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $678.00 / $678.00 / $678.00	Facility		$678.00	$678.00	$678.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $673.73 / $973.62 / $1,663.36	Professional		$673.73	$973.62	$1,663.36
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $820.29 / $820.29 / $911.04	Facility		$820.29	$820.29	$911.04
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $802.92 / $820.29 / $911.04	Professional		$802.92	$820.29	$911.04
United Facility/Professional Facility Modifier Low / Median / High Price $2,228.00 / $3,879.00 / $7,508.00	Facility		$2,228.00	$3,879.00	$7,508.00
United Facility/Professional Professional Modifier Low / Median / High Price $803.90 / $995.10 / $1,708.41	Professional		$803.90	$995.10	$1,708.41