Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.10 / $36.38 / $49.75	Facility		$22.10	$36.38	$49.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.84 / $22.83 / $56.09	Professional		$15.84	$22.83	$56.09
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $25.35 / $25.35 / $25.35	Professional	CQ	$25.35	$25.35	$25.35
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $20.09 / $20.09 / $20.09	Professional		$20.09	$20.09	$20.09
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 $30.73 / $31.80 / $53.97	Professional		$30.73	$31.80	$53.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.80 / $65.00 / $75.00	Facility		$55.80	$65.00	$75.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.22 / $41.28 / $111.17	Professional		$21.22	$41.28	$111.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $37.60 / $78.67 / $110.00	Professional		$37.60	$78.67	$110.00
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.80 / $78.72 / $80.95	Facility		$57.80	$78.72	$80.95
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.88 / $25.88 / $27.53	Professional		$25.88	$25.88	$27.53
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $20.09 / $20.09 / $20.09	Professional		$20.09	$20.09	$20.09
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $22.10 / $36.38 / $49.75	Facility		$22.10	$36.38	$49.75
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $15.84 / $23.67 / $57.88	Professional		$15.84	$23.67	$57.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $22.30 / $40.50 / $65.20	Professional		$22.30	$40.50	$65.20
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $55.80 / $65.00 / $75.00	Facility		$55.80	$65.00	$75.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $21.22 / $41.28 / $113.94	Professional		$21.22	$41.28	$113.94
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $25.48 / $32.95 / $32.95	Facility		$25.48	$32.95	$32.95
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $25.48 / $32.95 / $34.90	Professional		$25.48	$32.95	$34.90
United Facility/Professional Professional Modifier Low / Median / High Price $26.98 / $34.52 / $50.87	Professional		$26.98	$34.52	$50.87