Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $75.86 / $123.03	Facility		$27.54	$75.86	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $22.91 / $47.86	Professional		$16.98	$22.91	$47.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $12.30 / $12.30	Professional		$12.30	$12.30	$12.30
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $141.25 / $5,011.87	Facility		$104.71	$141.25	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $46.77	Professional		$22.91	$22.91	$46.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $44.67 / $100.00	Facility		$19.50	$44.67	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.49 / $26.30 / $53.70	Professional		$13.49	$26.30	$53.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $38.02 / $54.95	Professional		$20.42	$38.02	$54.95
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $29.51 / $29.51	Facility		$29.51	$29.51	$29.51
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $33.88 / $56.23	Professional		$21.88	$33.88	$56.23
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $72.44 / $123.03	Facility		$27.54	$72.44	$123.03
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $26.30 / $104.71	Professional		$16.98	$26.30	$104.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Professional		$56.23	$56.23	$56.23
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $7.41 / $25.12 / $26.30	Facility		$7.41	$25.12	$26.30
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $7.41 / $25.12 / $29.51	Professional		$7.41	$25.12	$29.51
United Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $29.51 / $34.67	Facility		$29.51	$29.51	$34.67
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $17.38 / $36.31	Professional		$12.30	$17.38	$36.31