Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $108.01 / $129.94 / $1,359.00	Facility		$108.01	$129.94	$1,359.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $98.09 / $220.39	Professional		$73.42	$98.09	$220.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $108.87 / $197.39 / $197.39	Professional		$108.87	$197.39	$197.39
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $112.49 / $119.31 / $148.38	Professional		$112.49	$119.31	$148.38
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 $94.83 / $115.78 / $195.67	Professional		$94.83	$115.78	$195.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.95 / $114.74 / $147.96	Facility		$31.95	$114.74	$147.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.32 / $105.25 / $181.17	Professional		$61.32	$105.25	$181.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $139.34 / $179.15 / $185.09	Professional		$139.34	$179.15	$185.09
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.19 / $117.15 / $189.02	Professional		$102.19	$117.15	$189.02
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $112.49 / $117.01 / $148.38	Professional		$112.49	$117.01	$148.38
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $60.75 / $129.94 / $1,812.00	Facility		$60.75	$129.94	$1,812.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $73.42 / $110.29 / $220.39	Professional		$73.42	$110.29	$220.39
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $28.40 / $105.25 / $177.05	Professional		$28.40	$105.25	$177.05
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $31.95 / $64.94 / $132.72	Facility		$31.95	$64.94	$132.72
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $61.32 / $110.51 / $181.17	Professional		$61.32	$110.51	$181.17
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $48.32 / $111.59 / $111.59	Facility		$48.32	$111.59	$111.59
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $48.32 / $111.59 / $122.85	Professional		$48.32	$111.59	$122.85
United Facility/Professional Facility Modifier Low / Median / High Price $81.93 / $155.19 / $210.49	Facility		$81.93	$155.19	$210.49
United Facility/Professional Professional Modifier Low / Median / High Price $60.35 / $110.93 / $219.02	Professional		$60.35	$110.93	$219.02