Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,326.37 / $2,326.37 / $2,954.49	Facility		$2,326.37	$2,326.37	$2,954.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $2,326.37 / $2,326.37 / $2,326.37	Professional		$2,326.37	$2,326.37	$2,326.37
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,813.82 / $2,133.91 / $8,639.91	Facility		$1,813.82	$2,133.91	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $2,133.91 / $2,133.91 / $2,133.91	Professional		$2,133.91	$2,133.91	$2,133.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,554.44 / $2,554.44 / $2,554.44	Facility		$2,554.44	$2,554.44	$2,554.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,554.44 / $2,554.44 / $2,554.44	Professional		$2,554.44	$2,554.44	$2,554.44
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $2,326.37 / $2,326.37 / $3,931.57	Facility		$2,326.37	$2,326.37	$3,931.57
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $2,326.37 / $2,326.37 / $2,736.91	Professional		$2,326.37	$2,326.37	$2,736.91
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $2,554.44 / $2,554.44 / $2,554.44	Facility		$2,554.44	$2,554.44	$2,554.44
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $2,554.44 / $2,554.44 / $2,554.44	Professional		$2,554.44	$2,554.44	$2,554.44
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $169.06 / $169.06 / $169.06	Facility		$169.06	$169.06	$169.06
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $169.06 / $169.06 / $169.06	Professional		$169.06	$169.06	$169.06
United Facility/Professional Professional Modifier Low / Median / High Price $2,349.17 / $2,736.91 / $4,299.00	Professional		$2,349.17	$2,736.91	$4,299.00