Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.64 / $41.58 / $270.83	Facility		$21.64	$41.58	$270.83
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $85.62 / $196.35 / $4,812.29	Facility	CO	$85.62	$196.35	$4,812.29
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $60.83 / $228.99 / $1,816.99	Facility	CQ	$60.83	$228.99	$1,816.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.98 / $23.69 / $183.00	Professional		$14.98	$23.69	$183.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $19.68 / $19.68 / $25.05	Professional		$19.68	$19.68	$25.05
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 / $54.47	Professional		$31.18	$32.26	$54.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.13 / $57.72 / $75.00	Facility		$39.13	$57.72	$75.00
Cigna Facility/Professional Facility Modifier CO Low / Median / High Price $31.05 / $31.05 / $31.05	Facility	CO	$31.05	$31.05	$31.05
Cigna Facility/Professional Facility Modifier CQ Low / Median / High Price $31.05 / $31.05 / $31.05	Facility	CQ	$31.05	$31.05	$31.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.46 / $60.00 / $111.17	Professional		$25.46	$60.00	$111.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $92.55	Professional		$45.00	$45.00	$92.55
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $37.86 / $80.73 / $138.44	Facility		$37.86	$80.73	$138.44
Highmark BCBS Facility/Professional Facility Modifier CO Low / Median / High Price $9.25 / $46.60 / $53.49	Facility	CO	$9.25	$46.60	$53.49
Highmark BCBS Facility/Professional Facility Modifier CQ Low / Median / High Price $57.93 / $57.93 / $122.00	Facility	CQ	$57.93	$57.93	$122.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.42 / $28.42 / $28.42	Professional		$28.42	$28.42	$28.42
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $30.75 / $30.75 / $33.34	Facility		$30.75	$30.75	$33.34
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $19.68 / $19.68 / $25.05	Professional		$19.68	$19.68	$25.05
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $22.69 / $57.09 / $363.77	Facility		$22.69	$57.09	$363.77
Martin's Point Facility/Professional Facility Modifier CO Low / Median / High Price $86.06 / $266.39 / $1,083.32	Facility	CO	$86.06	$266.39	$1,083.32
Martin's Point Facility/Professional Facility Modifier CQ Low / Median / High Price $103.18 / $228.99 / $1,578.53	Facility	CQ	$103.18	$228.99	$1,578.53
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $19.28 / $27.37 / $182.52	Professional		$19.28	$27.37	$182.52
Martin's Point Facility/Professional Professional Modifier CQ Low / Median / High Price $25.67 / $25.67 / $27.25	Professional	CQ	$25.67	$25.67	$27.25
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $34.20 / $75.50	Professional		$21.38	$34.20	$75.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $39.13 / $57.72 / $75.00	Facility		$39.13	$57.72	$75.00
Priority Health Facility/Professional Facility Modifier CO Low / Median / High Price $31.05 / $31.05 / $31.05	Facility	CO	$31.05	$31.05	$31.05
Priority Health Facility/Professional Facility Modifier CQ Low / Median / High Price $31.05 / $31.05 / $31.05	Facility	CQ	$31.05	$31.05	$31.05
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $27.20 / $61.95 / $113.01	Professional		$27.20	$61.95	$113.01
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $29.29 / $32.00 / $32.00	Facility		$29.29	$32.00	$32.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $29.29 / $32.00 / $33.86	Professional		$29.29	$32.00	$33.86
United Facility/Professional Professional Modifier Low / Median / High Price $27.82 / $33.84 / $52.45	Professional		$27.82	$33.84	$52.45