Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $18.80 / $57.28 / $308.10	Facility		$18.80	$57.28	$308.10
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $16.30 / $113.98 / $817.29	Facility	CQ	$16.30	$113.98	$817.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.53 / $21.42 / $149.75	Professional		$15.53	$21.42	$149.75
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $17.64 / $17.64 / $133.80	Professional	CO	$17.64	$17.64	$133.80
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $15.48 / $22.74 / $117.00	Professional	CQ	$15.48	$22.74	$117.00
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $14.80 / $17.70 / $19.63	Professional	CQ	$14.80	$17.70	$19.63
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $16.17 / $16.17 / $20.58	Professional		$16.17	$16.17	$20.58
AmeriHealth Facility/Professional Professional Modifier 52 Low / Median / High Price $12.13 / $12.13 / $16.17	Professional	52	$12.13	$12.13	$16.17
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 $27.59 / $28.55 / $58.95	Professional		$27.59	$28.55	$58.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.03 / $65.00 / $75.00	Facility		$50.03	$65.00	$75.00
Cigna Facility/Professional Facility Modifier CQ Low / Median / High Price $25.67 / $25.67 / $25.67	Facility	CQ	$25.67	$25.67	$25.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.14 / $56.05 / $111.17	Professional		$21.14	$56.05	$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 $31.40 / $69.15 / $82.00	Facility		$31.40	$69.15	$82.00
Highmark BCBS Facility/Professional Facility Modifier CQ Low / Median / High Price $34.33 / $46.24 / $72.95	Facility	CQ	$34.33	$46.24	$72.95
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.93 / $23.18 / $25.04	Professional		$10.93	$23.18	$25.04
Highmark BCBS Facility/Professional Professional Modifier CQ Low / Median / High Price $24.05 / $24.05 / $24.05	Professional	CQ	$24.05	$24.05	$24.05
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $26.20 / $26.20 / $28.25	Facility		$26.20	$26.20	$28.25
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $16.17 / $16.17 / $20.58	Professional		$16.17	$16.17	$20.58
Independence Blue Cross Facility/Professional Professional Modifier 52 Low / Median / High Price $12.13 / $12.13 / $16.17	Professional	52	$12.13	$12.13	$16.17
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $19.75 / $69.61 / $367.82	Facility		$19.75	$69.61	$367.82
Martin's Point Facility/Professional Facility Modifier CQ Low / Median / High Price $41.41 / $135.41 / $725.39	Facility	CQ	$41.41	$135.41	$725.39
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $16.04 / $22.68 / $111.00	Professional		$16.04	$22.68	$111.00
Martin's Point Facility/Professional Professional Modifier CO Low / Median / High Price $87.28 / $87.28 / $87.28	Professional	CO	$87.28	$87.28	$87.28
Martin's Point Facility/Professional Professional Modifier CQ Low / Median / High Price $13.50 / $26.72 / $79.55	Professional	CQ	$13.50	$26.72	$79.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $10.90 / $39.29 / $57.16	Professional		$10.90	$39.29	$57.16
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $50.03 / $65.00 / $75.00	Facility		$50.03	$65.00	$75.00
Priority Health Facility/Professional Facility Modifier CQ Low / Median / High Price $25.67 / $25.67 / $25.67	Facility	CQ	$25.67	$25.67	$25.67
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $22.84 / $60.82 / $113.01	Professional		$22.84	$60.82	$113.01
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $26.58 / $26.58 / $28.19	Facility		$26.58	$26.58	$28.19
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $26.11 / $26.58 / $28.19	Professional		$26.11	$26.58	$28.19
United Facility/Professional Professional Modifier Low / Median / High Price $23.84 / $28.05 / $42.69	Professional		$23.84	$28.05	$42.69