Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.64 / $229.10 / $422.70	Facility		$115.64	$229.10	$422.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.50 / $141.19 / $211.62	Professional		$109.50	$141.19	$211.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $105.77 / $129.41 / $212.40	Professional		$105.77	$129.41	$212.40
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $151.99 / $151.99 / $594.00	Facility		$151.99	$151.99	$594.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $107.00 / $138.78 / $273.08	Professional		$107.00	$138.78	$273.08
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $173.61 / $211.03 / $296.25	Professional		$173.61	$211.03	$296.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $246.37 / $246.37 / $246.37	Facility		$246.37	$246.37	$246.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $147.94 / $261.72	Professional		$96.00	$147.94	$261.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $79.00 / $251.60	Professional		$79.00	$79.00	$251.60
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.55 / $178.41 / $578.24	Facility		$95.55	$178.41	$578.24
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.25 / $156.87 / $212.51	Professional		$133.25	$156.87	$212.51
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $119.44 / $119.44 / $119.44	Professional	25	$119.44	$119.44	$119.44
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $151.99 / $594.00	Facility		$115.00	$151.99	$594.00
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $101.92 / $135.76 / $273.08	Professional		$101.92	$135.76	$273.08
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $115.64 / $248.82 / $423.00	Facility		$115.64	$248.82	$423.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $143.30 / $240.55	Professional		$105.00	$143.30	$240.55
Optum Facility/Professional Professional Modifier Low / Median / High Price $98.08 / $148.63 / $215.31	Professional		$98.08	$148.63	$215.31
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,259.39 / $1,259.39 / $1,345.86	Facility		$1,259.39	$1,259.39	$1,345.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $142.41 / $201.96	Professional		$88.00	$142.41	$201.96
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $246.37 / $246.37 / $246.37	Facility		$246.37	$246.37	$246.37
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $146.97 / $242.56	Professional		$85.00	$146.97	$242.56
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $107.81 / $136.41 / $171.77	Facility		$107.81	$136.41	$171.77
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $105.30 / $145.80 / $171.77	Professional		$105.30	$145.80	$171.77
United Facility/Professional Professional Modifier Low / Median / High Price $112.50 / $159.16 / $282.70	Professional		$112.50	$159.16	$282.70