Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $407.38 / $457.09	Facility		$48.98	$407.38	$457.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $41.69 / $114.82	Professional		$30.20	$41.69	$114.82
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $109.65 / $204.17 / $223.87	Professional	22	$109.65	$204.17	$223.87
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $19.95 / $40.74 / $112.20	Professional	52	$19.95	$40.74	$112.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $38.90 / $60.26	Professional		$32.36	$38.90	$60.26
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $15.14 / $15.14 / $15.14	Professional	52	$15.14	$15.14	$15.14
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $104.71	Professional		$36.31	$36.31	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $51.29 / $125.89	Facility		$33.88	$51.29	$125.89
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $40.74 / $40.74 / $40.74	Facility	52	$40.74	$40.74	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $43.65 / $70.79	Professional		$28.84	$43.65	$70.79
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $50.12 / $75.86	Professional		$41.69	$50.12	$75.86
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $75.86	Professional		$34.67	$46.77	$75.86
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $45.71 / $64.57	Professional		$41.69	$45.71	$64.57
Highmark BCBS Facility/Professional Professional Modifier 22 Low / Median / High Price $48.98 / $50.12 / $53.70	Professional	22	$48.98	$50.12	$53.70
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $22.39 / $26.92 / $32.36	Professional	52	$22.39	$26.92	$32.36
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $39.81 / $52.48	Professional		$33.88	$39.81	$52.48
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $407.38 / $457.09	Facility		$38.02	$407.38	$457.09
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $39.81 / $104.71	Professional		$30.20	$39.81	$104.71
Martin's Point Facility/Professional Professional Modifier 22 Low / Median / High Price $109.65 / $204.17 / $223.87	Professional	22	$109.65	$204.17	$223.87
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $19.95 / $42.66 / $114.82	Professional	52	$19.95	$42.66	$114.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $58.88 / $63.10	Professional		$58.88	$58.88	$63.10
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $35.48 / $79.43	Professional		$12.88	$35.48	$79.43
United Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $363.08 / $363.08	Facility		$363.08	$363.08	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $36.31 / $61.66	Professional		$25.70	$36.31	$61.66