Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.35 / $154.51 / $422.70	Facility		$112.35	$154.51	$422.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.62 / $126.85 / $192.11	Professional		$96.62	$126.85	$192.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.41 / $115.02 / $185.07	Professional		$94.41	$115.02	$185.07
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $137.22 / $137.22 / $137.22	Facility		$137.22	$137.22	$137.22
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $81.31 / $132.94 / $200.00	Professional		$81.31	$132.94	$200.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $160.69 / $201.26 / $262.18	Professional		$160.69	$201.26	$262.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $231.96 / $231.96	Facility		$60.00	$231.96	$231.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $131.09 / $233.36	Professional		$79.00	$131.09	$233.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $65.00 / $231.72	Professional		$65.00	$65.00	$231.72
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.70 / $153.85 / $195.00	Facility		$89.70	$153.85	$195.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.24 / $138.07 / $195.00	Professional		$120.24	$138.07	$195.00
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $137.22 / $137.22 / $154.57	Facility		$137.22	$137.22	$154.57
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $129.32 / $205.95	Professional		$78.00	$129.32	$205.95
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $117.96 / $213.60 / $422.70	Facility		$117.96	$213.60	$422.70
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $85.00 / $136.12 / $218.43	Professional		$85.00	$136.12	$218.43
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $442.00 / $442.00 / $442.00	Professional	25	$442.00	$442.00	$442.00
Optum Facility/Professional Professional Modifier Low / Median / High Price $83.00 / $127.32 / $181.40	Professional		$83.00	$127.32	$181.40
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $279.43 / $279.43 / $279.43	Facility		$279.43	$279.43	$279.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $82.75 / $121.79 / $169.13	Professional		$82.75	$121.79	$169.13
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $231.96 / $231.96	Facility		$60.00	$231.96	$231.96
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $129.00 / $226.62	Professional		$78.00	$129.00	$226.62
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $102.70 / $108.76 / $144.66	Facility		$102.70	$108.76	$144.66
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $105.84 / $131.13 / $149.22	Professional		$105.84	$131.13	$149.22
United Facility/Professional Professional Modifier Low / Median / High Price $105.43 / $145.65 / $254.26	Professional		$105.43	$145.65	$254.26