Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $951.97 / $5,079.00 / $9,788.00	Facility		$951.97	$5,079.00	$9,788.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $132.01 / $146.13 / $146.13	Facility	53	$132.01	$146.13	$146.13
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $495.05 / $548.01 / $548.01	Facility	54	$495.05	$548.01	$548.01
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $99.01 / $109.60 / $109.60	Facility	55	$99.01	$109.60	$109.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $584.94 / $677.44 / $1,090.59	Professional		$584.94	$677.44	$1,090.59
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $95.35 / $102.32 / $129.24	Professional	55	$95.35	$102.32	$129.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $479.94 / $479.94 / $658.57	Professional		$479.94	$479.94	$658.57
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 $668.28 / $693.50 / $1,049.18	Professional		$668.28	$693.50	$1,049.18
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 $535.88 / $775.85 / $1,274.89	Professional		$535.88	$775.85	$1,274.89
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $802.18 / $802.18 / $1,034.43	Professional		$802.18	$802.18	$1,034.43
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,367.04 / $13,920.78 / $30,874.25	Facility		$4,367.04	$13,920.78	$30,874.25
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $798.30 / $832.91 / $1,377.52	Professional		$798.30	$832.91	$1,377.52
Highmark BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $154.27 / $164.15 / $166.59	Professional	55	$154.27	$164.15	$166.59
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,013.00 / $5,403.00 / $10,527.00	Facility		$1,013.00	$5,403.00	$10,527.00
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $146.13 / $146.13 / $146.13	Facility	53	$146.13	$146.13	$146.13
Martin's Point Facility/Professional Facility Modifier 54 Low / Median / High Price $548.01 / $548.01 / $548.01	Facility	54	$548.01	$548.01	$548.01
Martin's Point Facility/Professional Facility Modifier 55 Low / Median / High Price $109.60 / $109.60 / $109.60	Facility	55	$109.60	$109.60	$109.60
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $591.99 / $774.52 / $2,020.00	Professional		$591.99	$774.52	$2,020.00
Martin's Point Facility/Professional Professional Modifier 55 Low / Median / High Price $95.35 / $102.32 / $138.09	Professional	55	$95.35	$102.32	$138.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $687.12 / $1,010.48 / $1,723.30	Professional		$687.12	$1,010.48	$1,723.30
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 $537.34 / $777.93 / $1,325.26	Professional		$537.34	$777.93	$1,325.26
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $654.58 / $654.58 / $726.07	Facility		$654.58	$654.58	$726.07
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $641.36 / $654.58 / $726.07	Professional		$641.36	$654.58	$726.07
United Facility/Professional Facility Modifier Low / Median / High Price $1,843.00 / $3,742.00 / $7,000.00	Facility		$1,843.00	$3,742.00	$7,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $653.29 / $827.30 / $1,342.60	Professional		$653.29	$827.30	$1,342.60