Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.94 / $62.42 / $362.60	Facility		$24.94	$62.42	$362.60
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $124.23 / $221.94 / $1,900.99	Facility	CO	$124.23	$221.94	$1,900.99
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $36.65 / $173.53 / $520.13	Facility	CQ	$36.65	$173.53	$520.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.77 / $29.45 / $211.65	Professional		$17.77	$29.45	$211.65
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $152.00 / $152.00 / $152.00	Professional	CO	$152.00	$152.00	$152.00
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $47.10 / $47.10 / $145.00	Professional	CQ	$47.10	$47.10	$145.00
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $20.68 / $22.33 / $32.86	Professional	CQ	$20.68	$22.33	$32.86
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $23.02 / $23.02 / $29.30	Professional		$23.02	$23.02	$29.30
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 $31.18 / $32.26 / $56.00	Professional		$31.18	$32.26	$56.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $67.06 / $75.00	Facility		$65.00	$67.06	$75.00
Cigna Facility/Professional Facility Modifier CO Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	CO	$34.86	$34.86	$34.86
Cigna Facility/Professional Facility Modifier CQ Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	CQ	$34.86	$34.86	$34.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.99 / $60.82 / $111.17	Professional		$26.99	$60.82	$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 $43.03 / $85.57 / $102.50	Facility		$43.03	$85.57	$102.50
Highmark BCBS Facility/Professional Facility Modifier CO Low / Median / High Price $47.20 / $106.04 / $137.11	Facility	CO	$47.20	$106.04	$137.11
Highmark BCBS Facility/Professional Facility Modifier CQ Low / Median / High Price $56.12 / $75.79 / $128.07	Facility	CQ	$56.12	$75.79	$128.07
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.00 / $13.00 / $34.60	Professional		$13.00	$13.00	$34.60
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $36.07 / $36.07 / $36.07	Facility		$36.07	$36.07	$36.07
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $23.02 / $23.02 / $29.30	Professional		$23.02	$23.02	$29.30
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $26.12 / $89.34 / $390.10	Facility		$26.12	$89.34	$390.10
Martin's Point Facility/Professional Facility Modifier CO Low / Median / High Price $115.20 / $221.94 / $460.80	Facility	CO	$115.20	$221.94	$460.80
Martin's Point Facility/Professional Facility Modifier CQ Low / Median / High Price $85.22 / $190.00 / $520.13	Facility	CQ	$85.22	$190.00	$520.13
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $20.25 / $30.27 / $157.00	Professional		$20.25	$30.27	$157.00
Martin's Point Facility/Professional Professional Modifier CO Low / Median / High Price $152.00 / $152.00 / $152.00	Professional	CO	$152.00	$152.00	$152.00
Martin's Point Facility/Professional Professional Modifier CQ Low / Median / High Price $30.73 / $50.99 / $145.00	Professional	CQ	$30.73	$50.99	$145.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $24.84 / $49.68 / $72.44	Professional		$24.84	$49.68	$72.44
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $67.06 / $75.00	Facility		$65.00	$67.06	$75.00
Priority Health Facility/Professional Facility Modifier CO Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	CO	$34.86	$34.86	$34.86
Priority Health Facility/Professional Facility Modifier CQ Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	CQ	$34.86	$34.86	$34.86
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $28.15 / $62.87 / $113.01	Professional		$28.15	$62.87	$113.01
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $32.39 / $36.08 / $36.08	Facility		$32.39	$36.08	$36.08
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $32.39 / $36.08 / $38.39	Professional		$32.39	$36.08	$38.39
United Facility/Professional Professional Modifier Low / Median / High Price $27.24 / $36.95 / $56.23	Professional		$27.24	$36.95	$56.23