Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $524.81 / $1,023.29	Facility		$199.53	$524.81	$1,023.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $162.18 / $346.74	Professional		$125.89	$162.18	$346.74
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 $331.13 / $331.13 / $338.84	Professional		$331.13	$331.13	$338.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $524.81 / $1,023.29	Facility		$239.88	$524.81	$1,023.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $165.96 / $323.59	Professional		$102.33	$165.96	$323.59
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $229.09	Professional		$190.55	$190.55	$229.09
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $173.78 / $269.15	Professional		$97.72	$173.78	$269.15
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $363.08 / $812.83	Facility		$199.53	$363.08	$812.83
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $177.83 / $562.34	Professional		$134.90	$177.83	$562.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $380.19	Professional		$199.53	$257.04	$380.19
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $69.18 / $147.91	Facility		$35.48	$69.18	$147.91
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $69.18 / $309.03	Professional		$35.48	$69.18	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $1,148.15 / $1,412.54	Facility		$602.56	$1,148.15	$1,412.54
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $190.55 / $331.13	Professional		$114.82	$190.55	$331.13