Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $134.90 / $194.98	Facility		$72.44	$134.90	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $102.33	Professional		$72.44	$72.44	$102.33
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $77.62 / $5,011.87	Facility		$66.07	$77.62	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Professional		$74.13	$74.13	$74.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Facility		$72.44	$72.44	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Professional		$72.44	$72.44	$72.44
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $74.13	Facility		$74.13	$74.13	$74.13
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $128.82 / $128.82	Professional		$109.65	$128.82	$128.82
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $120.23 / $194.98	Facility		$72.44	$120.23	$194.98
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $109.65	Professional		$72.44	$72.44	$109.65
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $85.11 / $85.11	Facility		$74.13	$85.11	$85.11
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $85.11 / $389.05	Professional		$74.13	$85.11	$389.05
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $77.62 / $97.72	Professional		$74.13	$77.62	$97.72