Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $741.31 / $1,174.90	Facility		$234.42	$741.31	$1,174.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $213.80 / $691.83	Professional		$186.21	$213.80	$691.83
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,511.38 / $77,624.71	Facility		$5,011.87	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $389.05 / $741.31	Facility		$162.18	$389.05	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $288.40 / $371.54	Professional		$117.49	$288.40	$371.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $147.91 / $363.08	Professional		$117.49	$147.91	$363.08
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $251.19 / $251.19	Facility		$251.19	$251.19	$251.19
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $269.15 / $436.52	Professional		$213.80	$269.15	$436.52
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $741.31 / $1,174.90	Facility		$234.42	$741.31	$1,174.90
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $234.42 / $741.31	Professional		$181.97	$234.42	$741.31
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $251.19 / $295.12	Facility		$234.42	$251.19	$295.12
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $257.04 / $295.12	Professional		$234.42	$257.04	$295.12
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $251.19 / $302.00	Facility		$138.04	$251.19	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $154.88 / $354.81	Professional		$104.71	$154.88	$354.81