Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.39 / $142.01 / $191.50	Facility		$80.39	$142.01	$191.50
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $79.87 / $141.76 / $201.88	Facility	25	$79.87	$141.76	$201.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $75.51 / $121.10	Professional		$40.00	$75.51	$121.10
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $68.78 / $95.14 / $171.63	Professional	25	$68.78	$95.14	$171.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.64 / $82.94 / $147.15	Professional		$75.64	$82.94	$147.15
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $81.68 / $89.18 / $99.52	Professional	25	$81.68	$89.18	$99.52
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $78.03 / $99.09 / $160.41	Professional		$78.03	$99.09	$160.41
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $86.21 / $89.46 / $141.13	Professional		$86.21	$89.46	$141.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.94 / $79.94 / $79.94	Facility		$79.94	$79.94	$79.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.30 / $69.92 / $114.97	Professional		$41.30	$69.92	$114.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $55.00 / $134.25	Professional		$25.00	$55.00	$134.25
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $71.65 / $71.65 / $71.65	Facility		$71.65	$71.65	$71.65
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $71.34 / $71.34 / $83.57	Facility	25	$71.34	$71.34	$83.57
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.57 / $80.48 / $103.43	Professional		$45.57	$80.48	$103.43
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $75.80 / $80.73 / $146.54	Professional	25	$75.80	$80.73	$146.54
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $83.27 / $94.58 / $155.88	Professional		$83.27	$94.58	$155.88
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $80.39 / $142.01 / $191.50	Facility		$80.39	$142.01	$191.50
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $79.87 / $141.76 / $201.88	Facility	25	$79.87	$141.76	$201.88
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $44.96 / $78.31 / $144.65	Professional		$44.96	$78.31	$144.65
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $76.23 / $96.95 / $176.46	Professional	25	$76.23	$96.95	$176.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $60.80 / $60.80 / $138.63	Professional		$60.80	$60.80	$138.63
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $79.94 / $79.94 / $79.94	Facility		$79.94	$79.94	$79.94
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $40.29 / $70.38 / $116.45	Professional		$40.29	$70.38	$116.45
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $48.08 / $59.98 / $88.20	Professional		$48.08	$59.98	$88.20
United Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $82.00 / $140.93	Professional		$50.00	$82.00	$140.93