Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.20 / $111.00 / $219.38	Facility		$50.20	$111.00	$219.38
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $141.57 / $150.22 / $217.10	Facility	25	$141.57	$150.22	$217.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.19 / $72.28 / $154.29	Professional		$40.19	$72.28	$154.29
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $48.43 / $85.03 / $156.69	Professional	25	$48.43	$85.03	$156.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $51.00 / $88.34 / $130.57	Professional		$51.00	$88.34	$130.57
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $50.00 / $72.98 / $108.99	Professional	25	$50.00	$72.98	$108.99
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $48.86 / $48.86 / $48.86	Facility		$48.86	$48.86	$48.86
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $61.54 / $81.64 / $101.48	Professional		$61.54	$81.64	$101.48
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $197.00 / $8,639.91 / $79,506.39	Facility		$197.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $77.67 / $121.44	Professional		$75.00	$77.67	$121.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.64 / $147.00 / $194.00	Facility		$62.64	$147.00	$194.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.38 / $72.01 / $116.28	Professional		$46.38	$72.01	$116.28
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $102.17 / $102.17 / $102.17	Facility		$102.17	$102.17	$102.17
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $71.83 / $90.92 / $146.15	Professional		$71.83	$90.92	$146.15
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $195.87 / $195.87 / $195.87	Facility		$195.87	$195.87	$195.87
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.46 / $77.17 / $112.96	Professional		$52.46	$77.17	$112.96
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $51.18 / $75.34 / $98.80	Professional	25	$51.18	$75.34	$98.80
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $48.86 / $48.86 / $48.86	Facility		$48.86	$48.86	$48.86
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $61.54 / $82.32 / $134.87	Professional		$61.54	$82.32	$134.87
Johns Hopkins Employer Health Plan Facility/Professional Facility Modifier Low / Median / High Price $73.26 / $73.26 / $73.26	Facility		$73.26	$73.26	$73.26
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $73.26 / $73.26 / $111.40	Professional		$73.26	$73.26	$111.40
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $39.85 / $74.20 / $201.08	Facility		$39.85	$74.20	$201.08
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $135.16 / $150.22 / $217.10	Facility	25	$135.16	$150.22	$217.10
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $45.34 / $79.45 / $154.58	Professional		$45.34	$79.45	$154.58
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $49.08 / $87.36 / $156.83	Professional	25	$49.08	$87.36	$156.83
Optum Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $78.09 / $93.09	Professional		$42.00	$78.09	$93.09
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $140.86 / $140.86 / $292.80	Facility		$140.86	$140.86	$292.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $80.09 / $153.69	Professional		$55.00	$80.09	$153.69
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $62.64 / $135.00 / $190.00	Facility		$62.64	$135.00	$190.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $46.57 / $72.38 / $119.19	Professional		$46.57	$72.38	$119.19
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $46.93 / $70.01 / $74.18	Facility		$46.93	$70.01	$74.18
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $68.59 / $74.31	Professional		$46.93	$68.59	$74.31
United Facility/Professional Professional Modifier Low / Median / High Price $60.58 / $78.29 / $137.93	Professional		$60.58	$78.29	$137.93