Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.62 / $309.51 / $628.29	Facility		$142.62	$309.51	$628.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.62 / $142.63 / $202.25	Professional		$142.62	$142.63	$202.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $142.63 / $142.63	Professional		$142.63	$142.63	$142.63
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $404.10 / $404.10 / $404.10	Facility		$404.10	$404.10	$404.10
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $117.44 / $142.63 / $142.63	Facility		$117.44	$142.63	$142.63
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $111.25 / $111.25 / $111.25	Professional		$111.25	$111.25	$111.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.49 / $185.42 / $473.76	Facility		$95.49	$185.42	$473.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.72 / $117.59 / $225.34	Professional		$73.72	$117.59	$225.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $84.86 / $192.55 / $271.00	Professional		$84.86	$192.55	$271.00
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $251.47 / $360.14 / $594.00	Facility		$251.47	$360.14	$594.00
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $20.51 / $404.10 / $511.97	Facility		$20.51	$404.10	$511.97
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $170.04 / $170.04 / $170.04	Professional		$170.04	$170.04	$170.04
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $102.69 / $307.00 / $628.29	Facility		$102.69	$307.00	$628.29
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $142.62 / $156.03 / $423.61	Professional		$142.62	$156.03	$423.61
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,003.93 / $2,169.82 / $2,663.12	Facility		$1,003.93	$2,169.82	$2,663.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $142.60 / $162.40 / $285.26	Professional		$142.60	$162.40	$285.26
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $95.49 / $185.42 / $473.76	Facility		$95.49	$185.42	$473.76
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $75.09 / $120.17 / $234.12	Professional		$75.09	$120.17	$234.12
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $142.63 / $142.63	Facility		$142.63	$142.63	$142.63
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $142.63 / $142.63	Professional		$142.63	$142.63	$142.63
United Facility/Professional Professional Modifier Low / Median / High Price $59.90 / $91.28 / $237.60	Professional		$59.90	$91.28	$237.60