Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $40.74 / $165.96	Facility		$19.95	$40.74	$165.96
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $53.70 / $114.82 / $288.40	Facility	CQ	$53.70	$114.82	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $23.99 / $141.25	Professional		$15.85	$23.99	$141.25
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $18.62 / $32.36 / $70.79	Professional	CQ	$18.62	$32.36	$70.79
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 $25.70 / $26.92 / $26.92	Professional		$25.70	$26.92	$26.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $75.86 / $125.89	Facility		$46.77	$75.86	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $25.70 / $51.29	Professional		$14.13	$25.70	$51.29
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $81.28	Professional		$34.67	$34.67	$81.28
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $31.62 / $54.95	Professional		$28.18	$31.62	$54.95
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $52.48 / $74.13	Facility		$13.18	$52.48	$74.13
Highmark BCBS Facility/Professional Facility Modifier CQ Low / Median / High Price $8.71 / $75.86 / $87.10	Facility	CQ	$8.71	$75.86	$87.10
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $23.99 / $26.30	Professional		$23.99	$23.99	$26.30
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $20.42 / $40.74 / $181.97	Facility		$20.42	$40.74	$181.97
Martin's Point Facility/Professional Facility Modifier CQ Low / Median / High Price $53.70 / $120.23 / $295.12	Facility	CQ	$53.70	$120.23	$295.12
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $25.12 / $70.79	Professional		$16.98	$25.12	$70.79
Martin's Point Facility/Professional Professional Modifier CQ Low / Median / High Price $18.62 / $33.88 / $83.18	Professional	CQ	$18.62	$33.88	$83.18
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $151.36 / $190.55	Facility		$131.83	$151.36	$190.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $31.62 / $75.86	Professional		$30.20	$31.62	$75.86
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $12.30 / $15.49 / $28.84	Facility		$12.30	$15.49	$28.84
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $19.05 / $50.12	Professional		$12.30	$19.05	$50.12
United Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $31.62 / $32.36	Facility		$28.84	$31.62	$32.36
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.84 / $42.66	Professional		$21.88	$28.84	$42.66