Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.11 / $30.15 / $369.00	Facility		$24.11	$30.15	$369.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.72 / $27.62 / $91.00	Professional		$19.72	$27.62	$91.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.37 / $30.07 / $38.32	Professional		$19.37	$30.07	$38.32
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $27.35 / $28.31	Professional		$25.02	$27.35	$28.31
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 $20.83 / $27.95 / $54.28	Professional		$20.83	$27.95	$54.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $21.60 / $21.60 / $756.00	Facility		$21.60	$21.60	$756.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.22 / $27.87 / $44.73	Professional		$20.22	$27.87	$44.73
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $44.86 / $44.86 / $44.86	Facility		$44.86	$44.86	$44.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $18.50 / $24.11 / $42.75	Professional		$18.50	$24.11	$42.75
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.68 / $169.41 / $588.10	Facility		$114.68	$169.41	$588.10
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.25 / $28.82 / $141.05	Professional		$24.25	$28.82	$141.05
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $25.02 / $27.35 / $28.31	Professional		$25.02	$27.35	$28.31
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $24.11 / $120.31 / $369.00	Facility		$24.11	$120.31	$369.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $20.10 / $31.26 / $72.81	Professional		$20.10	$31.26	$72.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.33 / $40.00 / $53.20	Professional		$30.33	$40.00	$53.20
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $21.60 / $21.60 / $756.00	Facility		$21.60	$21.60	$756.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $20.22 / $27.97 / $47.10	Professional		$20.22	$27.97	$47.10
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $20.61 / $20.61 / $20.61	Facility		$20.61	$20.61	$20.61
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $20.16 / $20.61 / $21.33	Professional		$20.16	$20.61	$21.33
United Facility/Professional Professional Modifier Low / Median / High Price $20.11 / $27.93 / $41.74	Professional		$20.11	$27.93	$41.74