Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $540.00 / $2,105.81 / $7,175.00	Facility		$540.00	$2,105.81	$7,175.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $11,833.36 / $11,833.36 / $11,833.36	Facility	50	$11,833.36	$11,833.36	$11,833.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.03 / $246.81 / $485.82	Professional		$138.03	$246.81	$485.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $342.56 / $377.10 / $388.74	Professional	50	$342.56	$377.10	$388.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $235.94 / $250.20 / $277.92	Professional		$235.94	$250.20	$277.92
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $270.24 / $322.02 / $443.33	Professional		$270.24	$322.02	$443.33
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $990.00 / $2,838.15 / $6,846.16	Facility		$990.00	$2,838.15	$6,846.16
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $265.20 / $275.22 / $620.47	Professional		$265.20	$275.22	$620.47
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $397.82 / $578.69 / $930.71	Professional	50	$397.82	$578.69	$930.71
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 $136.59 / $250.22 / $418.50	Professional		$136.59	$250.22	$418.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $327.67 / $327.67 / $422.54	Professional		$327.67	$327.67	$422.54
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $667.54 / $2,542.94 / $5,591.41	Facility		$667.54	$2,542.94	$5,591.41
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,241.83 / $1,241.83 / $3,422.80	Facility	50	$1,241.83	$1,241.83	$3,422.80
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.06 / $310.82 / $338.73	Professional		$178.06	$310.82	$338.73
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $503.43 / $503.43 / $508.10	Professional	50	$503.43	$503.43	$508.10
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $270.24 / $322.02 / $443.33	Professional		$270.24	$322.02	$443.33
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $652.00 / $3,077.00 / $8,017.00	Facility		$652.00	$3,077.00	$8,017.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $11,833.36 / $11,833.36 / $11,833.36	Facility	50	$11,833.36	$11,833.36	$11,833.36
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $149.96 / $271.50 / $715.30	Professional		$149.96	$271.50	$715.30
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $342.56 / $377.10 / $1,936.50	Professional	50	$342.56	$377.10	$1,936.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $209.47 / $307.10 / $499.00	Professional		$209.47	$307.10	$499.00
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 $140.74 / $249.63 / $377.24	Professional		$140.74	$249.63	$377.24
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $151.28 / $180.47 / $566.75	Facility		$151.28	$180.47	$566.75
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $150.55 / $266.45 / $566.75	Professional		$150.55	$266.45	$566.75
United Facility/Professional Facility Modifier Low / Median / High Price $637.00 / $1,734.00 / $4,300.00	Facility		$637.00	$1,734.00	$4,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $246.98 / $325.18 / $537.76	Professional		$246.98	$325.18	$537.76