Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $83.18 / $1,862.09	Facility		$19.95	$83.18	$1,862.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $19.95 / $31.62	Professional		$15.85	$19.95	$31.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $15.14 / $23.44	Professional		$12.88	$15.14	$23.44
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 $16.98 / $19.95 / $28.84	Professional		$16.98	$19.95	$28.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $275.42 / $354.81	Facility		$31.62	$275.42	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $23.44 / $40.74	Professional		$17.78	$23.44	$40.74
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $30.90 / $44.67	Professional		$23.44	$30.90	$44.67
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $22.39 / $35.48	Professional		$19.50	$22.39	$35.48
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $20.89 / $20.89	Professional		$19.05	$20.89	$20.89
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $83.18 / $1,862.09	Facility		$19.95	$83.18	$1,862.09
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $20.89 / $42.66	Professional		$16.98	$20.89	$42.66
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $40.74 / $40.74	Facility		$40.74	$40.74	$40.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $40.74 / $52.48	Professional		$33.11	$40.74	$52.48
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $19.95 / $26.92	Facility		$18.20	$19.95	$26.92
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $18.20 / $27.54	Professional		$8.71	$18.20	$27.54
United Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $389.05 / $478.63	Facility		$199.53	$389.05	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $16.60 / $21.38 / $33.88	Professional		$16.60	$21.38	$33.88