Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,523.96 / $8,833.86 / $13,031.90	Facility		$2,523.96	$8,833.86	$13,031.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $320.58 / $2,523.96 / $20,035.90	Professional		$320.58	$2,523.96	$20,035.90
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $8,639.91 / $13,977.01 / $21,244.65	Facility		$8,639.91	$13,977.01	$21,244.65
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $2,430.48 / $2,430.48 / $2,430.48	Professional		$2,430.48	$2,430.48	$2,430.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,957.08 / $4,603.02 / $10,340.12	Facility		$2,957.08	$4,603.02	$10,340.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,468.20 / $3,327.81 / $7,047.36	Professional		$1,468.20	$3,327.81	$7,047.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,854.02 / $4,206.60 / $5,920.40	Professional		$1,854.02	$4,206.60	$5,920.40
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $2,648.60 / $8,833.86 / $12,869.10	Facility		$2,648.60	$8,833.86	$12,869.10
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,963.08 / $2,648.60 / $12,869.10	Professional		$1,963.08	$2,648.60	$12,869.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $4,611.68 / $4,674.00 / $6,232.00	Professional		$4,611.68	$4,674.00	$6,232.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $3,032.90 / $5,184.01 / $10,340.12	Facility		$3,032.90	$5,184.01	$10,340.12
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $2,024.75 / $3,335.52 / $7,047.36	Professional		$2,024.75	$3,335.52	$7,047.36
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $933.74 / $3,116.00 / $3,116.00	Facility		$933.74	$3,116.00	$3,116.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $933.74 / $3,116.00 / $3,116.00	Professional		$933.74	$3,116.00	$3,116.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,308.72 / $1,869.60 / $4,362.39	Professional		$1,308.72	$1,869.60	$4,362.39