Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.84 / $168.70 / $400.88	Facility		$59.84	$168.70	$400.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.32 / $126.86 / $260.14	Professional		$86.32	$126.86	$260.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $90.90 / $93.78 / $130.00	Professional		$90.90	$93.78	$130.00
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $441.10 / $441.10 / $441.10	Facility		$441.10	$441.10	$441.10
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $71.31 / $5,000.00 / $77,850.02	Facility		$71.31	$5,000.00	$77,850.02
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $129.63 / $134.52 / $134.52	Professional		$129.63	$134.52	$134.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.59 / $189.99 / $264.33	Facility		$107.59	$189.99	$264.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.85 / $180.19 / $284.67	Professional		$100.85	$180.19	$284.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $155.81 / $210.46 / $220.97	Professional		$155.81	$210.46	$220.97
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.67 / $140.75 / $233.29	Facility		$36.67	$140.75	$233.29
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.91 / $140.11 / $154.41	Professional		$134.91	$140.11	$154.41
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $441.10 / $441.10 / $558.84	Facility		$441.10	$441.10	$558.84
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $66.64 / $179.14 / $430.00	Facility		$66.64	$179.14	$430.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $129.61 / $376.77	Professional		$60.00	$129.61	$376.77
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $291.63 / $314.62 / $405.69	Facility		$291.63	$314.62	$405.69
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $17.23 / $46.88 / $71.13	Professional		$17.23	$46.88	$71.13
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $105.31 / $173.43 / $283.33	Facility		$105.31	$173.43	$283.33
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $102.95 / $178.39 / $283.17	Professional		$102.95	$178.39	$283.17
United Facility/Professional Professional Modifier Low / Median / High Price $120.69 / $153.28 / $252.89	Professional		$120.69	$153.28	$252.89