Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $52.48 / $87.10	Facility		$18.62	$52.48	$87.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $18.20 / $36.31	Professional		$14.13	$18.20	$36.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.80 / $13.80 / $13.80	Professional		$13.80	$13.80	$13.80
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $141.25 / $5,011.87	Facility		$107.15	$141.25	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $15.49 / $15.49 / $44.67	Professional		$15.49	$15.49	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $32.36 / $67.61	Facility		$18.62	$32.36	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $12.02 / $19.05 / $44.67	Professional		$12.02	$19.05	$44.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $26.30 / $38.02	Professional		$14.13	$26.30	$38.02
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Facility		$19.95	$19.95	$19.95
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $30.20 / $51.29	Professional		$20.89	$30.20	$51.29
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $52.48 / $87.10	Facility		$18.62	$52.48	$87.10
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $19.95 / $72.44	Professional		$14.79	$19.95	$72.44
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.18 / $28.18	Professional		$28.18	$28.18	$28.18
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $27.54 / $27.54	Facility		$24.55	$27.54	$27.54
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $27.54 / $27.54	Professional		$24.55	$27.54	$27.54
United Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $23.99	Facility		$19.95	$19.95	$23.99
United Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $12.02 / $31.62	Professional		$8.51	$12.02	$31.62