Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $169.82 / $398.11	Facility		$100.00	$169.82	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $95.50 / $275.42	Professional		$64.57	$95.50	$275.42
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,511.38 / $77,624.71	Facility		$5,011.87	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $114.82 / $190.55	Professional		$112.20	$114.82	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $95.50 / $151.36	Facility		$64.57	$95.50	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $117.49 / $190.55	Professional		$93.33	$117.49	$190.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $147.91 / $181.97	Professional		$81.28	$147.91	$181.97
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $120.23 / $190.55	Professional		$97.72	$120.23	$190.55
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $162.18 / $398.11	Facility		$100.00	$162.18	$398.11
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $269.15	Professional		$72.44	$107.15	$269.15
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $281.84	Professional		$93.33	$93.33	$281.84
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $97.72 / $309.03	Facility		$64.57	$97.72	$309.03
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $107.15 / $575.44	Professional		$47.86	$107.15	$575.44
United Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $123.03 / $123.03	Facility		$112.20	$123.03	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $100.00 / $173.78	Professional		$77.62	$100.00	$173.78