Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $16.39 / $143.99 / $319.00	Facility		$16.39	$143.99	$319.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.13 / $23.19 / $76.00	Professional		$13.13	$23.19	$76.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $20.07 / $20.07 / $87.00	Professional	25	$20.07	$20.07	$87.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $12.36 / $17.28 / $24.04	Professional		$12.36	$17.28	$24.04
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $122.43 / $218.53 / $772.34	Facility		$122.43	$218.53	$772.34
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $14.62 / $19.48 / $47.65	Professional		$14.62	$19.48	$47.65
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $15.42 / $21.22 / $48.78	Professional		$15.42	$21.22	$48.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $18.05 / $18.05 / $756.00	Facility		$18.05	$18.05	$756.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $13.68 / $22.79 / $37.61	Professional		$13.68	$22.79	$37.61
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $31.84 / $31.84 / $31.84	Facility		$31.84	$31.84	$31.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $15.54 / $22.14 / $72.45	Professional		$15.54	$22.14	$72.45
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.04 / $120.62 / $157.25	Facility		$72.04	$120.62	$157.25
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.54 / $23.85 / $75.40	Professional		$16.54	$23.85	$75.40
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $31.58 / $31.58 / $31.58	Professional	25	$31.58	$31.58	$31.58
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $122.43 / $237.50 / $552.91	Facility		$122.43	$237.50	$552.91
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $14.57 / $19.48 / $45.96	Professional		$14.57	$19.48	$45.96
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $17.05 / $157.25 / $319.00	Facility		$17.05	$157.25	$319.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $13.13 / $23.75 / $58.76	Professional		$13.13	$23.75	$58.76
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $20.07 / $22.78 / $87.00	Professional	25	$20.07	$22.78	$87.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,003.93 / $3,000.07 / $3,741.34	Facility		$1,003.93	$3,000.07	$3,741.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.68 / $34.40 / $47.20	Professional		$9.68	$34.40	$47.20
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $18.05 / $18.05 / $756.00	Facility		$18.05	$18.05	$756.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $13.68 / $22.38 / $35.35	Professional		$13.68	$22.38	$35.35
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $13.96 / $13.96 / $30.00	Facility		$13.96	$13.96	$30.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $13.66 / $14.87 / $30.00	Professional		$13.66	$14.87	$30.00
United Facility/Professional Professional Modifier Low / Median / High Price $14.62 / $20.34 / $32.54	Professional		$14.62	$20.34	$32.54