Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.29 / $930.61 / $4,761.00	Facility		$122.29	$930.61	$4,761.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $455.62 / $638.86 / $2,118.75	Facility	50	$455.62	$638.86	$2,118.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.82 / $118.62 / $359.79	Professional		$84.82	$118.62	$359.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $41.49 / $189.41 / $590.00	Professional	50	$41.49	$189.41	$590.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.44 / $113.92 / $171.10	Professional		$104.44	$113.92	$171.10
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $156.66 / $170.87 / $256.64	Professional	50	$156.66	$170.87	$256.64
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $117.20 / $139.47 / $625.87	Professional		$117.20	$139.47	$625.87
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,299.82 / $2,746.00 / $13,822.74	Facility		$2,299.82	$2,746.00	$13,822.74
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $110.71 / $161.16 / $344.38	Professional		$110.71	$161.16	$344.38
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $166.06 / $248.70 / $516.57	Professional	50	$166.06	$248.70	$516.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $358.00 / $358.00 / $358.00	Facility		$358.00	$358.00	$358.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.85 / $132.18 / $257.95	Professional		$85.85	$132.18	$257.95
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $133.63 / $133.63 / $172.34	Professional		$133.63	$133.63	$172.34
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $449.54 / $721.81 / $1,914.85	Facility		$449.54	$721.81	$1,914.85
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $661.49 / $1,082.70 / $2,973.48	Facility	50	$661.49	$1,082.70	$2,973.48
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.67 / $138.27 / $236.70	Professional		$109.67	$138.27	$236.70
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $168.63 / $207.41 / $591.00	Professional	50	$168.63	$207.41	$591.00
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $113.92 / $139.47 / $625.87	Professional		$113.92	$139.47	$625.87
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $445.90 / $1,777.00 / $7,175.00	Facility		$445.90	$1,777.00	$7,175.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $638.86 / $759.67 / $2,555.28	Facility	50	$638.86	$759.67	$2,555.28
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $88.07 / $124.56 / $468.53	Professional		$88.07	$124.56	$468.53
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $90.41 / $204.33 / $702.79	Professional	50	$90.41	$204.33	$702.79
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $534.50 / $552.30 / $3,923.00	Facility		$534.50	$552.30	$3,923.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $138.69 / $432.90 / $432.90	Professional		$138.69	$432.90	$432.90
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $358.00 / $358.00 / $358.00	Facility		$358.00	$358.00	$358.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $83.55 / $125.33 / $222.38	Professional		$83.55	$125.33	$222.38
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $88.22 / $109.08 / $513.08	Facility		$88.22	$109.08	$513.08
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $87.99 / $108.39 / $513.08	Professional		$87.99	$108.39	$513.08
United Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $650.00 / $4,300.00	Facility		$144.00	$650.00	$4,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $97.78 / $141.51 / $237.26	Professional		$97.78	$141.51	$237.26