Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $138.04 / $169.82	Facility		$74.13	$138.04	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $25.70 / $56.23	Professional		$18.62	$25.70	$56.23
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $107.15 / $107.15 / $107.15	Professional	50	$107.15	$107.15	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $25.12 / $25.12	Professional		$22.91	$25.12	$25.12
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $25.70 / $46.77	Professional		$24.55	$25.70	$46.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $26.30 / $41.69	Professional		$17.78	$26.30	$41.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $41.69	Professional		$30.20	$30.20	$41.69
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $27.54 / $41.69	Professional		$23.99	$27.54	$41.69
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $30.20 / $30.20	Professional		$27.54	$30.20	$30.20
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $33.11	Professional		$25.12	$25.12	$33.11
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $138.04 / $169.82	Facility		$74.13	$138.04	$169.82
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $25.12 / $43.65	Professional		$19.05	$25.12	$43.65
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $107.15 / $107.15 / $107.15	Professional	50	$107.15	$107.15	$107.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $28.18	Professional		$27.54	$27.54	$28.18
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $23.44 / $28.84	Professional		$17.78	$23.44	$28.84
United Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $165.96	Facility		$165.96	$165.96	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $23.44 / $34.67	Professional		$15.14	$23.44	$34.67