Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $354.81 / $575.44	Facility		$128.82	$354.81	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $112.20 / $251.19	Professional		$89.13	$112.20	$251.19
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $501.19 / $660.69 / $5,011.87	Facility		$501.19	$660.69	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $107.15 / $223.87	Professional		$107.15	$107.15	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $223.87 / $467.74	Facility		$134.90	$223.87	$467.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $120.23 / $239.88	Professional		$63.10	$120.23	$239.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $177.83 / $263.03	Professional		$95.50	$177.83	$263.03
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $158.49 / $257.04	Professional		$102.33	$158.49	$257.04
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $338.84 / $575.44	Facility		$128.82	$338.84	$575.44
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $512.86	Professional		$89.13	$123.03	$512.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $389.05	Professional		$194.98	$194.98	$389.05
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $114.82 / $177.83	Facility		$67.61	$114.82	$177.83
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $114.82 / $177.83	Professional		$67.61	$114.82	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $165.96	Facility		$138.04	$138.04	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $81.28 / $169.82	Professional		$57.54	$81.28	$169.82