Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.50 / $96.46 / $3,239.87	Facility		$50.50	$96.46	$3,239.87
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $10.38 / $95.02 / $1,459.08	Facility	50	$10.38	$95.02	$1,459.08
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $17.36 / $20.98 / $25.26	Facility	52	$17.36	$20.98	$25.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.38 / $52.88 / $129.66	Professional		$29.38	$52.88	$129.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $57.86 / $93.57 / $252.73	Professional	50	$57.86	$93.57	$252.73
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.69 / $20.98 / $29.98	Professional	52	$14.69	$20.98	$29.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.06 / $72.61 / $89.22	Professional		$39.06	$72.61	$89.22
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $80.20 / $112.00 / $112.00	Professional	50	$80.20	$112.00	$112.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $49.53 / $51.53 / $56.66	Professional		$49.53	$51.53	$56.66
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $47.76 / $90.03 / $111.87	Professional		$47.76	$90.03	$111.87
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $47.29 / $75.40 / $160.59	Professional	50	$47.29	$75.40	$160.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $53.86 / $91.22	Professional		$33.95	$53.86	$91.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $74.25 / $75.59	Professional		$56.10	$74.25	$75.59
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.43 / $171.43 / $302.00	Facility		$42.43	$171.43	$302.00
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $64.88 / $200.32 / $307.25	Facility	50	$64.88	$200.32	$307.25
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $49.53 / $51.53 / $63.34	Professional		$49.53	$51.53	$63.34
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $50.50 / $428.00 / $5,342.00	Facility		$50.50	$428.00	$5,342.00
Martin's Point Facility/Professional Facility Modifier 50 Low / Median / High Price $70.48 / $262.77 / $2,535.00	Facility	50	$70.48	$262.77	$2,535.00
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $17.36 / $25.26 / $109.72	Facility	52	$17.36	$25.26	$109.72
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $31.73 / $57.87 / $124.76	Professional		$31.73	$57.87	$124.76
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $59.78 / $93.57 / $246.00	Professional	50	$59.78	$93.57	$246.00
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $14.69 / $22.00 / $42.85	Professional	52	$14.69	$22.00	$42.85
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $95.48 / $95.48 / $95.48	Facility		$95.48	$95.48	$95.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4.00 / $78.09 / $121.90	Professional		$4.00	$78.09	$121.90
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $34.75 / $55.24 / $95.15	Professional		$34.75	$55.24	$95.15
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $31.98 / $46.21 / $55.03	Facility		$31.98	$46.21	$55.03
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $31.98 / $45.11 / $51.68	Professional		$31.98	$45.11	$51.68
United Facility/Professional Facility Modifier Low / Median / High Price $162.00 / $577.00 / $3,742.00	Facility		$162.00	$577.00	$3,742.00
United Facility/Professional Professional Modifier Low / Median / High Price $41.45 / $58.93 / $98.42	Professional		$41.45	$58.93	$98.42