Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,584.89 / $2,511.89	Facility		$537.03	$1,584.89	$2,511.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $501.19 / $1,071.52	Professional		$436.52	$501.19	$1,071.52
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $3,090.30 / $4,073.80 / $5,754.40	Facility		$3,090.30	$4,073.80	$5,754.40
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $575.44	Professional		$457.09	$457.09	$575.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $891.25 / $1,995.26	Facility		$389.05	$891.25	$1,995.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $660.69 / $912.01	Professional		$338.84	$660.69	$912.01
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $338.84 / $831.76	Professional		$275.42	$338.84	$831.76
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $575.44 / $575.44	Facility		$575.44	$575.44	$575.44
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $645.65 / $1,000.00	Professional		$575.44	$645.65	$1,000.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,513.56 / $2,570.40	Facility		$537.03	$1,513.56	$2,570.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $549.54 / $2,137.96	Professional		$426.58	$549.54	$2,137.96
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $812.83 / $812.83	Facility		$575.44	$812.83	$812.83
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $575.44 / $812.83	Professional		$467.74	$575.44	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $575.44 / $691.83	Facility		$389.05	$575.44	$691.83
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $380.19 / $1,000.00	Professional		$245.47	$380.19	$1,000.00