Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $90.42 / $142.36	Facility		$30.90	$90.42	$142.36
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $50.92 / $164.64 / $221.97	Facility	25	$50.92	$164.64	$221.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.83 / $110.48 / $164.26	Professional		$50.83	$110.48	$164.26
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $27.70 / $123.70 / $255.08	Professional	25	$27.70	$123.70	$255.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.50 / $121.01 / $188.00	Professional		$115.50	$121.01	$188.00
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $107.41 / $120.92 / $208.26	Professional	25	$107.41	$120.92	$208.26
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $109.58 / $139.43 / $220.21	Professional		$109.58	$139.43	$220.21
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $122.43 / $127.05 / $281.86	Professional		$122.43	$127.05	$281.86
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $115.33 / $129.91 / $229.59	Professional	50	$115.33	$129.91	$229.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.68 / $120.68 / $120.68	Facility		$120.68	$120.68	$120.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.80 / $100.49 / $165.44	Professional		$60.80	$100.49	$165.44
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $70.00 / $189.41	Professional		$25.00	$70.00	$189.41
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.29 / $85.29 / $91.84	Facility		$85.29	$85.29	$91.84
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $70.27 / $78.73 / $78.81	Facility	25	$70.27	$78.73	$78.81
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.56 / $115.46 / $164.42	Professional		$90.56	$115.46	$164.42
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $68.66 / $114.57 / $127.50	Professional	25	$68.66	$114.57	$127.50
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $117.17 / $136.97 / $220.21	Professional		$117.17	$136.97	$220.21
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $30.90 / $90.42 / $142.36	Facility		$30.90	$90.42	$142.36
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $50.92 / $164.64 / $221.97	Facility	25	$50.92	$164.64	$221.97
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $66.53 / $113.90 / $197.49	Professional		$66.53	$113.90	$197.49
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $28.40 / $133.47 / $257.52	Professional	25	$28.40	$133.47	$257.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $87.40 / $87.40 / $194.75	Professional		$87.40	$87.40	$194.75
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $120.68 / $120.68 / $120.68	Facility		$120.68	$120.68	$120.68
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $62.76 / $101.91 / $173.42	Professional		$62.76	$101.91	$173.42
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $72.48 / $89.63 / $124.19	Professional		$72.48	$89.63	$124.19
United Facility/Professional Professional Modifier Low / Median / High Price $87.41 / $123.32 / $202.00	Professional		$87.41	$123.32	$202.00