Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $204.17 / $1,862.09	Facility		$147.91	$204.17	$1,862.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $147.91 / $338.84	Professional		$125.89	$147.91	$338.84
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 $138.04 / $141.25 / $257.04	Professional		$138.04	$141.25	$257.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $309.03 / $851.14	Facility		$46.77	$309.03	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $177.83 / $302.00	Professional		$134.90	$177.83	$302.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Facility		$263.03	$263.03	$263.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $162.18 / $229.09	Professional		$117.49	$162.18	$229.09
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $158.49 / $229.09	Professional		$117.49	$158.49	$229.09
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $218.78 / $1,862.09	Facility		$147.91	$218.78	$1,862.09
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $371.54	Professional		$128.82	$162.18	$371.54
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $281.84 / $346.74	Professional		$173.78	$281.84	$346.74
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $20.89 / $20.89 / $151.36	Facility		$20.89	$20.89	$151.36
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $134.90 / $186.21	Professional		$20.89	$134.90	$186.21
United Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $630.96 / $776.25	Facility		$323.59	$630.96	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $151.36 / $257.04	Professional		$114.82	$151.36	$257.04