Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $104.71 / $104.71	Facility		$63.10	$104.71	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $19.95 / $45.71	Professional		$15.85	$19.95	$45.71
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $199.53 / $213.80	Facility		$107.15	$199.53	$213.80
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $19.95 / $19.95	Professional		$19.95	$19.95	$19.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $50.12	Facility		$42.66	$42.66	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $24.55 / $48.98	Professional		$13.18	$24.55	$48.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $33.11 / $47.86	Professional		$17.78	$33.11	$47.86
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.11 / $56.23	Professional		$23.99	$33.11	$56.23
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $104.71 / $104.71	Facility		$63.10	$104.71	$104.71
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $21.38 / $77.62	Professional		$16.98	$21.38	$77.62
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $35.48 / $117.49	Professional		$35.48	$35.48	$117.49
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $22.39 / $30.20	Professional		$12.59	$22.39	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $25.12 / $38.02	Professional		$14.79	$25.12	$38.02