Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $436.52 / $707.95	Facility		$138.04	$436.52	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $134.90 / $309.03	Professional		$57.54	$134.90	$309.03
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $812.83 / $5,011.87	Facility		$616.60	$812.83	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $131.83 / $275.42	Professional		$131.83	$131.83	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $275.42 / $575.44	Facility		$165.96	$275.42	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $181.97 / $380.19	Professional		$79.43	$181.97	$380.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $218.78 / $323.59	Professional		$117.49	$218.78	$323.59
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Facility		$169.82	$169.82	$169.82
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $281.84 / $426.58	Professional		$169.82	$281.84	$426.58
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $426.58 / $707.95	Facility		$120.23	$426.58	$707.95
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $151.36 / $630.96	Professional		$57.54	$151.36	$630.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Professional		$239.88	$239.88	$239.88
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $141.25 / $169.82	Facility		$79.43	$141.25	$169.82
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $169.82	Professional		$79.43	$141.25	$169.82
United Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $204.17	Facility		$169.82	$169.82	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $102.33 / $208.93	Professional		$70.79	$102.33	$208.93