Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $50.12 / $269.15	Facility		$22.39	$50.12	$269.15
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $83.18 / $169.82 / $1,071.52	Facility	CO	$83.18	$169.82	$1,071.52
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $83.18 / $229.09 / $1,584.89	Facility	CQ	$83.18	$229.09	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $35.48 / $309.03	Professional		$19.95	$35.48	$309.03
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $27.54 / $27.54 / $81.28	Professional	CO	$27.54	$27.54	$81.28
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $20.42 / $26.92 / $81.28	Professional	CQ	$20.42	$26.92	$81.28
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 $38.02 / $66.07 / $85.11	Professional		$38.02	$66.07	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $75.86 / $125.89	Facility		$57.54	$75.86	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $31.62 / $60.26	Professional		$18.62	$31.62	$60.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $53.70 / $81.28	Professional		$42.66	$53.70	$81.28
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $37.15 / $66.07	Professional		$29.51	$37.15	$66.07
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $61.66 / $147.91	Facility		$44.67	$61.66	$147.91
Highmark BCBS Facility/Professional Facility Modifier CO Low / Median / High Price $9.33 / $77.62 / $102.33	Facility	CO	$9.33	$77.62	$102.33
Highmark BCBS Facility/Professional Facility Modifier CQ Low / Median / High Price $57.54 / $57.54 / $57.54	Facility	CQ	$57.54	$57.54	$57.54
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.54 / $27.54	Professional		$27.54	$27.54	$27.54
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $19.50 / $19.50	Professional		$14.79	$19.50	$19.50
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $50.12 / $269.15	Facility		$22.91	$50.12	$269.15
Martin's Point Facility/Professional Facility Modifier CO Low / Median / High Price $83.18 / $194.98 / $1,071.52	Facility	CO	$83.18	$194.98	$1,071.52
Martin's Point Facility/Professional Facility Modifier CQ Low / Median / High Price $60.26 / $229.09 / $1,584.89	Facility	CQ	$60.26	$229.09	$1,584.89
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $31.62 / $93.33	Professional		$19.95	$31.62	$93.33
Martin's Point Facility/Professional Professional Modifier CO Low / Median / High Price $27.54 / $27.54 / $81.28	Professional	CO	$27.54	$27.54	$81.28
Martin's Point Facility/Professional Professional Modifier CQ Low / Median / High Price $20.42 / $27.54 / $81.28	Professional	CQ	$20.42	$27.54	$81.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.88 / $77.62	Professional		$32.36	$33.88	$77.62
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $15.14 / $19.50 / $32.36	Facility		$15.14	$19.50	$32.36
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $15.14 / $22.91 / $32.36	Professional		$15.14	$22.91	$32.36
United Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $35.48 / $35.48	Facility		$32.36	$35.48	$35.48
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.11 / $48.98	Professional		$26.30	$33.11	$48.98