Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $338.84 / $707.95	Facility		$269.15	$338.84	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $295.12 / $707.95	Professional		$245.47	$295.12	$707.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $263.03 / $269.15	Professional		$208.93	$263.03	$269.15
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $281.84 / $5,011.87	Facility		$239.88	$281.84	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Facility		$269.15	$269.15	$269.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Professional		$269.15	$269.15	$269.15
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $269.15	Facility		$269.15	$269.15	$269.15
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $467.74 / $467.74	Professional		$407.38	$467.74	$467.74
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Professional		$281.84	$281.84	$281.84
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $269.15 / $707.95	Facility		$269.15	$269.15	$707.95
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $288.40 / $776.25	Professional		$251.19	$288.40	$776.25
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $288.40 / $302.00	Facility		$109.65	$288.40	$302.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $288.40 / $302.00	Professional		$109.65	$288.40	$302.00
United Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $245.47 / $257.04	Facility		$245.47	$245.47	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $288.40 / $363.08	Professional		$239.88	$288.40	$363.08