Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $142.63 / $253.50 / $589.05	Facility		$142.63	$253.50	$589.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.62 / $156.88 / $480.00	Professional		$142.62	$156.88	$480.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $228.21 / $228.21 / $278.13	Professional		$228.21	$228.21	$278.13
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $23.95 / $64.34 / $952.25	Facility		$23.95	$64.34	$952.25
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $151.36 / $237.60	Professional		$142.63	$151.36	$237.60
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 $161.66 / $352.83 / $668.27	Facility		$161.66	$352.83	$668.27
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.02 / $154.02 / $178.17	Professional		$154.02	$154.02	$178.17
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $28.09 / $60.24 / $205.96	Facility		$28.09	$60.24	$205.96
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $142.63 / $237.60	Professional		$142.63	$142.63	$237.60
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 $140.00 / $292.39 / $596.08	Facility		$140.00	$292.39	$596.08
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $142.62 / $171.15 / $589.05	Professional		$142.62	$171.15	$589.05
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $645.38 / $665.81 / $1,003.93	Facility		$645.38	$665.81	$1,003.93
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 $85.58 / $142.63 / $213.95	Professional		$85.58	$142.63	$213.95