Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.13 / $194.39 / $873.51	Facility		$128.13	$194.39	$873.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.00 / $156.99 / $228.57	Professional		$124.00	$156.99	$228.57
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $172.37 / $172.37 / $354.00	Professional	25	$172.37	$172.37	$354.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.41 / $175.17 / $299.55	Professional		$130.41	$175.17	$299.55
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $151.59 / $182.00 / $220.76	Professional		$151.59	$182.00	$220.76
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $195.07 / $231.85 / $332.80	Professional		$195.07	$231.85	$332.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $280.49 / $280.49 / $280.49	Facility		$280.49	$280.49	$280.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $170.13 / $324.50	Professional		$75.00	$170.13	$324.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $189.93 / $257.45 / $285.73	Professional		$189.93	$257.45	$285.73
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.12 / $219.00 / $222.40	Facility		$113.12	$219.00	$222.40
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.72 / $200.14 / $237.25	Professional		$176.72	$200.14	$237.25
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $158.10 / $200.69 / $224.77	Professional		$158.10	$200.69	$224.77
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $128.13 / $280.60 / $873.51	Facility		$128.13	$280.60	$873.51
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $124.32 / $166.36 / $277.88	Professional		$124.32	$166.36	$277.88
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $172.37 / $172.37 / $354.00	Professional	25	$172.37	$172.37	$354.00
Optum Facility/Professional Professional Modifier Low / Median / High Price $89.50 / $167.90 / $237.11	Professional		$89.50	$167.90	$237.11
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $733.90 / $733.90 / $1,208.09	Facility		$733.90	$733.90	$1,208.09
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.00 / $154.78 / $217.67	Professional		$83.00	$154.78	$217.67
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $280.49 / $280.49 / $280.49	Facility		$280.49	$280.49	$280.49
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $170.13 / $312.83	Professional		$75.00	$170.13	$312.83
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $111.43 / $114.32 / $192.66	Facility		$111.43	$114.32	$192.66
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $105.30 / $169.89 / $196.51	Professional		$105.30	$169.89	$196.51
United Facility/Professional Professional Modifier Low / Median / High Price $114.75 / $174.13 / $298.72	Professional		$114.75	$174.13	$298.72