Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $526.04 / $620.74 / $620.74	Facility		$526.04	$620.74	$620.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.95 / $121.74 / $352.28	Professional		$113.95	$121.74	$352.28
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $742.59 / $1,033.51 / $1,461.29	Facility		$742.59	$1,033.51	$1,461.29
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $117.23 / $117.23 / $117.23	Professional		$117.23	$117.23	$117.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $250.06 / $250.06 / $351.15	Facility		$250.06	$250.06	$351.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.25 / $144.47 / $301.24	Professional		$86.25	$144.47	$301.24
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $89.43 / $202.91 / $285.57	Professional		$89.43	$202.91	$285.57
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $620.74 / $620.74 / $620.74	Facility		$620.74	$620.74	$620.74
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $113.95 / $123.25 / $620.74	Professional		$113.95	$123.25	$620.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $165.80 / $225.45 / $358.40	Professional		$165.80	$225.45	$358.40
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $250.06 / $250.06 / $351.15	Facility		$250.06	$250.06	$351.15
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $87.06 / $167.43 / $339.48	Professional		$87.06	$167.43	$339.48
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $150.30 / $150.30 / $209.61	Professional		$150.30	$150.30	$209.61
United Facility/Professional Facility Modifier Low / Median / High Price $150.30 / $150.30 / $150.30	Facility		$150.30	$150.30	$150.30
United Facility/Professional Professional Modifier Low / Median / High Price $82.67 / $150.30 / $232.09	Professional		$82.67	$150.30	$232.09