Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $707.95 / $1,148.15	Facility		$223.87	$707.95	$1,148.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $194.98 / $602.56	Professional		$162.18	$194.98	$602.56
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,511.38 / $77,624.71	Facility		$5,011.87	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $234.42 / $389.05	Professional		$223.87	$234.42	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $194.98 / $407.38	Facility		$117.49	$194.98	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $165.96 / $363.08	Professional		$109.65	$165.96	$363.08
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $302.00 / $398.11	Professional		$165.96	$302.00	$398.11
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Facility		$93.33	$93.33	$93.33
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $288.40 / $524.81	Professional		$223.87	$288.40	$524.81
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $630.96 / $1,122.02	Facility		$223.87	$630.96	$1,122.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $912.01	Professional		$162.18	$218.78	$912.01
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $416.87 / $602.56	Professional		$331.13	$416.87	$602.56
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $199.53 / $218.78	Facility		$33.88	$199.53	$218.78
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $199.53 / $257.04	Professional		$33.88	$199.53	$257.04
United Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $2,344.23 / $2,884.03	Facility		$1,202.26	$2,344.23	$2,884.03
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $223.87 / $338.84	Professional		$123.03	$223.87	$338.84