Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.80 / $135.15 / $136.65	Facility		$105.80	$135.15	$136.65
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $136.65 / $136.65 / $136.65	Facility	25	$136.65	$136.65	$136.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.14 / $68.81 / $122.40	Professional		$39.14	$68.81	$122.40
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $60.00 / $75.40 / $92.20	Professional	25	$60.00	$75.40	$92.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.93 / $77.34 / $84.75	Professional		$71.93	$77.34	$84.75
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $84.52 / $84.52 / $85.17	Professional	25	$84.52	$84.52	$85.17
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $75.05 / $85.00 / $260.39	Professional		$75.05	$85.00	$260.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $78.75 / $85.07 / $155.12	Professional		$78.75	$85.07	$155.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.70 / $72.70 / $72.70	Facility		$72.70	$72.70	$72.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.96 / $66.56 / $107.00	Professional		$39.96	$66.56	$107.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $55.00 / $127.33	Professional		$25.00	$55.00	$127.33
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.46 / $74.70 / $96.19	Professional		$55.46	$74.70	$96.19
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $71.56 / $72.61 / $77.28	Professional	25	$71.56	$72.61	$77.28
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $75.05 / $84.75 / $260.39	Professional		$75.05	$84.75	$260.39
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $105.80 / $135.15 / $136.65	Facility		$105.80	$135.15	$136.65
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $136.65 / $136.65 / $136.65	Facility	25	$136.65	$136.65	$136.65
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $41.72 / $74.31 / $134.21	Professional		$41.72	$74.31	$134.21
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $71.94 / $78.04 / $92.20	Professional	25	$71.94	$78.04	$92.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $67.34 / $77.70 / $129.86	Professional		$67.34	$77.70	$129.86
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $72.70 / $72.70 / $72.70	Facility		$72.70	$72.70	$72.70
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $35.92 / $66.56 / $110.84	Professional		$35.92	$66.56	$110.84
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $44.45 / $66.28 / $83.94	Professional		$44.45	$66.28	$83.94
United Facility/Professional Professional Modifier Low / Median / High Price $57.11 / $79.43 / $125.29	Professional		$57.11	$79.43	$125.29