Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $313.42 / $684.33 / $1,477.10	Facility		$313.42	$684.33	$1,477.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $301.73 / $373.95 / $1,366.64	Professional		$301.73	$373.95	$1,366.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $270.36 / $270.36 / $270.36	Professional		$270.36	$270.36	$270.36
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $838.00 / $1,677.00 / $25,149.19	Facility		$838.00	$1,677.00	$25,149.19
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $847.02 / $5,000.00 / $77,850.02	Facility		$847.02	$5,000.00	$77,850.02
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $342.09 / $355.00 / $355.00	Professional		$342.09	$355.00	$355.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,091.50 / $1,307.74 / $2,189.02	Professional		$1,091.50	$1,307.74	$2,189.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $395.00 / $527.22 / $552.32	Professional		$395.00	$527.22	$552.32
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $687.48 / $1,537.30 / $2,773.76	Facility		$687.48	$1,537.30	$2,773.76
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $440.51 / $475.48 / $696.26	Professional		$440.51	$475.48	$696.26
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $758.40 / $1,456.00 / $16,000.35	Facility		$758.40	$1,456.00	$16,000.35
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $373.95 / $777.02 / $1,505.67	Facility		$373.95	$777.02	$1,505.67
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $313.42 / $373.95 / $1,477.10	Professional		$313.42	$373.95	$1,477.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,785.39 / $1,844.90 / $2,411.42	Facility		$1,785.39	$1,844.90	$2,411.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $474.20 / $714.00 / $1,044.64	Professional		$474.20	$714.00	$1,044.64
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,091.50 / $1,307.74 / $2,189.02	Professional		$1,091.50	$1,307.74	$2,189.02
United Facility/Professional Facility Modifier Low / Median / High Price $797.95 / $1,511.56 / $2,050.02	Facility		$797.95	$1,511.56	$2,050.02
United Facility/Professional Professional Modifier Low / Median / High Price $311.99 / $420.15 / $682.24	Professional		$311.99	$420.15	$682.24