Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,916.00 / $10,206.00 / $15,056.10	Facility		$2,916.00	$10,206.00	$15,056.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,160.00 / $2,916.00 / $3,060.00	Professional		$2,160.00	$2,916.00	$3,060.00
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $8,639.91 / $16,097.76 / $24,468.12	Facility		$8,639.91	$16,097.76	$24,468.12
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $2,808.00 / $2,808.00 / $2,808.00	Professional		$2,808.00	$2,808.00	$2,808.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,416.40 / $5,317.95 / $11,946.12	Facility		$3,416.40	$5,317.95	$11,946.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,658.09 / $3,325.06 / $6,450.14	Professional		$1,658.09	$3,325.06	$6,450.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,142.00 / $4,860.00 / $6,840.00	Professional		$2,142.00	$4,860.00	$6,840.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $3,060.00 / $10,206.00 / $14,868.00	Facility		$3,060.00	$10,206.00	$14,868.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $2,362.67 / $2,952.00 / $14,868.00	Professional		$2,362.67	$2,952.00	$14,868.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5,328.00 / $5,400.00 / $7,200.00	Professional		$5,328.00	$5,400.00	$7,200.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $3,503.91 / $5,989.23 / $11,946.12	Facility		$3,503.91	$5,989.23	$11,946.12
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,690.16 / $3,426.91 / $6,474.77	Professional		$1,690.16	$3,426.91	$6,474.77
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $3,600.00 / $3,600.00 / $3,960.00	Facility		$3,600.00	$3,600.00	$3,960.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $3,600.00 / $3,600.00 / $3,960.00	Professional		$3,600.00	$3,600.00	$3,960.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,512.00 / $2,160.00 / $5,040.00	Professional		$1,512.00	$2,160.00	$5,040.00