Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $167.03 / $288.48 / $726.00	Facility		$167.03	$288.48	$726.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.27 / $208.44 / $668.03	Professional		$162.27	$208.44	$668.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.27 / $264.12 / $355.19	Professional		$151.27	$264.12	$355.19
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $166.19 / $210.24 / $339.44	Professional		$166.19	$210.24	$339.44
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 $193.08 / $297.94 / $384.70	Professional		$193.08	$297.94	$384.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.74 / $216.61 / $673.34	Facility		$204.74	$216.61	$673.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.37 / $221.92 / $366.30	Professional		$153.37	$221.92	$366.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $199.20 / $245.71 / $293.83	Professional		$199.20	$245.71	$293.83
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.78 / $225.22 / $321.77	Professional		$205.78	$225.22	$321.77
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $193.61 / $205.46 / $339.44	Professional		$193.61	$205.46	$339.44
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $186.43 / $357.01 / $736.40	Facility		$186.43	$357.01	$736.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $165.59 / $258.64 / $520.00	Professional		$165.59	$258.64	$520.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $248.70 / $303.20 / $404.28	Professional		$248.70	$303.20	$404.28
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $204.74 / $216.61 / $673.34	Facility		$204.74	$216.61	$673.34
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $156.86 / $222.91 / $370.57	Professional		$156.86	$222.91	$370.57
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $187.31 / $187.31 / $187.31	Facility		$187.31	$187.31	$187.31
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $182.63 / $187.31 / $196.15	Professional		$182.63	$187.31	$196.15
United Facility/Professional Professional Modifier Low / Median / High Price $172.65 / $227.48 / $362.62	Professional		$172.65	$227.48	$362.62