Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $428.00 / $1,746.00 / $7,175.00	Facility		$428.00	$1,746.00	$7,175.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,131.13 / $1,131.13 / $2,593.13	Facility	50	$1,131.13	$1,131.13	$2,593.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.35 / $143.85 / $359.95	Professional		$110.35	$143.85	$359.95
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $58.32 / $239.28 / $1,159.50	Professional	50	$58.32	$239.28	$1,159.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.78 / $138.78 / $215.94	Professional		$138.78	$138.78	$215.94
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $184.09 / $184.09 / $208.18	Professional	50	$184.09	$184.09	$208.18
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $156.00 / $185.64 / $422.49	Professional		$156.00	$185.64	$422.49
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 $139.88 / $200.86 / $264.14	Professional		$139.88	$200.86	$264.14
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $209.82 / $304.95 / $396.19	Professional	50	$209.82	$304.95	$396.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.10 / $141.61 / $231.09	Professional		$101.10	$141.61	$231.09
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $170.07 / $170.07 / $219.31	Professional		$170.07	$170.07	$219.31
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $313.61 / $470.41 / $1,341.94	Facility		$313.61	$470.41	$1,341.94
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,812.06 / $1,812.06 / $2,012.93	Facility	50	$1,812.06	$1,812.06	$2,012.93
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.91 / $189.64 / $220.95	Professional		$164.91	$189.64	$220.95
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $250.20 / $288.02 / $355.58	Professional	50	$250.20	$288.02	$355.58
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $145.08 / $170.33 / $422.49	Professional		$145.08	$170.33	$422.49
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $641.00 / $1,819.00 / $7,799.00	Facility		$641.00	$1,819.00	$7,799.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $1,131.13 / $1,131.13 / $2,593.13	Facility	50	$1,131.13	$1,131.13	$2,593.13
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $113.62 / $157.61 / $450.00	Professional		$113.62	$157.61	$450.00
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $138.61 / $281.73 / $1,159.50	Professional	50	$138.61	$281.73	$1,159.50
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $159.80 / $291.39 / $291.39	Professional		$159.80	$291.39	$291.39
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $101.58 / $141.61 / $227.52	Professional		$101.58	$141.61	$227.52
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $112.52 / $140.66 / $204.21	Facility		$112.52	$140.66	$204.21
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $111.55 / $140.66 / $167.05	Professional		$111.55	$140.66	$167.05
United Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $674.00 / $4,300.00	Facility		$144.00	$674.00	$4,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $123.51 / $164.07 / $282.49	Professional		$123.51	$164.07	$282.49