Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,644.30 / $5,755.05 / $8,489.99	Facility		$1,644.30	$5,755.05	$8,489.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,320.80 / $1,644.30 / $13,052.90	Professional		$1,320.80	$1,644.30	$13,052.90
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,583.40 / $1,583.40 / $1,583.40	Professional		$1,583.40	$1,583.40	$1,583.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,926.47 / $2,999.03 / $6,736.94	Facility		$1,926.47	$2,999.03	$6,736.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $956.58 / $2,167.87 / $4,591.60	Professional		$956.58	$2,167.87	$4,591.60
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,207.84 / $2,740.50 / $3,857.00	Professional		$1,207.84	$2,740.50	$3,857.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,725.50 / $5,755.05 / $8,383.90	Facility		$1,725.50	$5,755.05	$8,383.90
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,320.80 / $1,725.50 / $8,383.90	Professional		$1,320.80	$1,725.50	$8,383.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3,004.40 / $3,045.00 / $4,060.00	Professional		$3,004.40	$3,045.00	$4,060.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,975.97 / $3,377.26 / $6,736.94	Facility		$1,975.97	$3,377.26	$6,736.94
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,068.83 / $2,173.21 / $4,591.60	Professional		$1,068.83	$2,173.21	$4,591.60
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $2,030.00 / $2,030.00 / $2,233.00	Facility		$2,030.00	$2,030.00	$2,233.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $2,030.00 / $2,030.00 / $2,233.00	Professional		$2,030.00	$2,030.00	$2,233.00
United Facility/Professional Professional Modifier Low / Median / High Price $852.60 / $1,218.00 / $2,842.00	Professional		$852.60	$1,218.00	$2,842.00