Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $204.17 / $316.23	Facility		$75.86	$204.17	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $251.19	Professional		$70.79	$100.00	$251.19
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $407.38 / $407.38 / $407.38	Professional	25	$407.38	$407.38	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $85.11 / $123.03	Professional		$63.10	$85.11	$123.03
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $120.23 / $173.78	Professional		$100.00	$120.23	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $60.26 / $154.88	Facility		$54.95	$60.26	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $93.33 / $151.36	Professional		$64.57	$93.33	$151.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $151.36 / $181.97	Professional		$112.20	$151.36	$181.97
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $75.86	Facility		$72.44	$72.44	$75.86
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $117.49 / $199.53	Professional		$83.18	$117.49	$199.53
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $112.20 / $138.04	Facility		$67.61	$112.20	$138.04
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $91.20 / $123.03	Professional		$79.43	$91.20	$123.03
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $102.33 / $131.83	Professional		$83.18	$102.33	$131.83
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $131.83 / $309.03	Facility		$74.13	$131.83	$309.03
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $100.00 / $204.17	Professional		$74.13	$100.00	$204.17
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $269.15 / $269.15 / $407.38	Professional	25	$269.15	$269.15	$407.38
Optum Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $125.89	Professional		$70.79	$95.50	$125.89
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $281.84 / $288.40	Facility		$91.20	$281.84	$288.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $147.91	Professional		$70.79	$95.50	$147.91
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $74.13 / $102.33	Professional		$22.39	$74.13	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $478.63 / $588.84	Facility		$316.23	$478.63	$588.84
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $95.50 / $165.96	Professional		$70.79	$95.50	$165.96