Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.52 / $525.66 / $802.99	Facility		$155.52	$525.66	$802.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.20 / $155.52 / $1,234.56	Professional		$50.20	$155.52	$1,234.56
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $288.99 / $385.09 / $8,459.92	Facility		$288.99	$385.09	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $149.76 / $149.76 / $149.76	Professional		$149.76	$149.76	$149.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.54 / $283.45 / $636.75	Facility		$128.54	$283.45	$636.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.63 / $90.41 / $286.83	Professional		$38.63	$90.41	$286.83
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $114.24 / $259.20 / $364.80	Professional		$114.24	$259.20	$364.80
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $525.66 / $792.96	Facility		$163.19	$525.66	$792.96
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $120.96 / $163.19 / $792.96	Professional		$120.96	$163.19	$792.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $273.60 / $284.16 / $384.00	Professional		$273.60	$284.16	$384.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $128.54 / $319.43 / $636.75	Facility		$128.54	$319.43	$636.75
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $38.63 / $91.96 / $286.83	Professional		$38.63	$91.96	$286.83
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $192.00 / $192.00 / $211.20	Facility		$192.00	$192.00	$211.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $192.00 / $192.00 / $211.20	Professional		$192.00	$192.00	$211.20
United Facility/Professional Professional Modifier Low / Median / High Price $78.94 / $115.20 / $240.00	Professional		$78.94	$115.20	$240.00