Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $478.63 / $645.65	Facility		$177.83	$478.63	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $151.36 / $204.17	Professional		$123.03	$151.36	$204.17
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,511.38 / $77,624.71	Facility		$5,011.87	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $181.97 / $181.97	Professional		$173.78	$181.97	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $251.19	Facility		$234.42	$234.42	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $199.53 / $331.13	Professional		$125.89	$199.53	$331.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $208.93 / $275.42	Professional		$169.82	$208.93	$275.42
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Facility		$154.88	$154.88	$154.88
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $120.23 / $251.19	Professional		$114.82	$120.23	$251.19
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $426.58 / $645.65	Facility		$177.83	$426.58	$645.65
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $154.88 / $245.47	Professional		$131.83	$154.88	$245.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $213.80 / $213.80	Professional		$199.53	$213.80	$213.80
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $107.15 / $173.78	Facility		$72.44	$107.15	$173.78
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $114.82 / $363.08	Professional		$72.44	$114.82	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $295.12	Professional		$131.83	$177.83	$295.12