Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.33 / $95.15 / $356.26	Facility		$21.33	$95.15	$356.26
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $24.06 / $135.41 / $553.74	Facility	CQ	$24.06	$135.41	$553.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.19 / $24.99 / $260.00	Professional		$16.19	$24.99	$260.00
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $110.73 / $110.73 / $110.73	Professional	CO	$110.73	$110.73	$110.73
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $25.58 / $39.27 / $80.53	Professional	CQ	$25.58	$39.27	$80.53
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $17.42 / $17.42 / $17.42	Professional	CQ	$17.42	$17.42	$17.42
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $26.03 / $26.03 / $26.03	Professional		$26.03	$26.03	$26.03
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $57,255.43 / $79,506.39	Facility		$5,000.00	$57,255.43	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $30.38 / $31.44 / $55.56	Professional		$30.38	$31.44	$55.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.55 / $65.00 / $75.00	Facility		$55.55	$65.00	$75.00
Cigna Facility/Professional Facility Modifier CQ Low / Median / High Price $32.00 / $32.00 / $32.00	Facility	CQ	$32.00	$32.00	$32.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.15 / $60.47 / $111.17	Professional		$25.15	$60.47	$111.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $94.00	Professional		$45.00	$45.00	$94.00
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.06 / $61.74 / $87.53	Facility		$47.06	$61.74	$87.53
Highmark BCBS Facility/Professional Facility Modifier CQ Low / Median / High Price $45.91 / $83.63 / $150.36	Facility	CQ	$45.91	$83.63	$150.36
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.63 / $28.31 / $28.90	Professional		$13.63	$28.31	$28.90
Highmark BCBS Facility/Professional Professional Modifier CQ Low / Median / High Price $28.90 / $28.90 / $28.90	Professional	CQ	$28.90	$28.90	$28.90
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $30.87 / $30.87 / $33.29	Facility		$30.87	$30.87	$33.29
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $26.03 / $26.03 / $26.03	Professional		$26.03	$26.03	$26.03
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $24.78 / $83.94 / $352.36	Facility		$24.78	$83.94	$352.36
Martin's Point Facility/Professional Facility Modifier CQ Low / Median / High Price $62.49 / $135.57 / $542.27	Facility	CQ	$62.49	$135.57	$542.27
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $19.36 / $27.40 / $153.00	Professional		$19.36	$27.40	$153.00
Martin's Point Facility/Professional Professional Modifier CQ Low / Median / High Price $24.94 / $39.27 / $80.53	Professional	CQ	$24.94	$39.27	$80.53
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $118.38 / $123.07 / $154.83	Facility		$118.38	$123.07	$154.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $23.15 / $46.30 / $66.58	Professional		$23.15	$46.30	$66.58
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $55.55 / $65.00 / $75.00	Facility		$55.55	$65.00	$75.00
Priority Health Facility/Professional Facility Modifier CQ Low / Median / High Price $32.00 / $32.00 / $32.00	Facility	CQ	$32.00	$32.00	$32.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $26.24 / $61.92 / $113.01	Professional		$26.24	$61.92	$113.01
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $27.21 / $33.06 / $33.06	Facility		$27.21	$33.06	$33.06
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $27.21 / $33.06 / $34.88	Professional		$27.21	$33.06	$34.88
United Facility/Professional Professional Modifier Low / Median / High Price $26.98 / $34.25 / $55.51	Professional		$26.98	$34.25	$55.51