Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.30 / $71.20 / $255.48	Facility		$17.30	$71.20	$255.48
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $61.42 / $139.65 / $184.80	Facility	25	$61.42	$139.65	$184.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.22 / $19.80 / $40.00	Professional		$7.22	$19.80	$40.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $15.65 / $26.01 / $46.63	Professional	25	$15.65	$26.01	$46.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $13.15 / $34.38 / $42.82	Professional		$13.15	$34.38	$42.82
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $19.70 / $21.71 / $50.00	Professional	25	$19.70	$21.71	$50.00
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $8.98 / $8.98 / $494.03	Facility		$8.98	$8.98	$494.03
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $20.41 / $24.05 / $47.93	Professional		$20.41	$24.05	$47.93
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 $23.98 / $31.22 / $46.55	Professional		$23.98	$31.22	$46.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11.66 / $147.00 / $194.00	Facility		$11.66	$147.00	$194.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.81 / $20.49 / $35.24	Professional		$8.81	$20.49	$35.24
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $18.89 / $18.89 / $18.89	Facility		$18.89	$18.89	$18.89
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $22.03 / $32.47 / $47.11	Professional		$22.03	$32.47	$47.11
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.45 / $107.60 / $148.19	Facility		$22.45	$107.60	$148.19
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $54.52 / $123.20 / $123.20	Facility	25	$54.52	$123.20	$123.20
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.12 / $26.01 / $38.07	Professional		$11.12	$26.01	$38.07
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $19.32 / $22.72 / $29.55	Professional	25	$19.32	$22.72	$29.55
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $8.98 / $8.98 / $494.03	Facility		$8.98	$8.98	$494.03
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $19.68 / $24.40 / $47.93	Professional		$19.68	$24.40	$47.93
Johns Hopkins Employer Health Plan Facility/Professional Facility Modifier Low / Median / High Price $13.33 / $13.33 / $13.33	Facility		$13.33	$13.33	$13.33
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $13.33 / $55.00 / $55.00	Professional		$13.33	$55.00	$55.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $12.41 / $59.68 / $261.95	Facility		$12.41	$59.68	$261.95
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $54.14 / $133.03 / $549.91	Facility	25	$54.14	$133.03	$549.91
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $8.42 / $22.35 / $42.96	Professional		$8.42	$22.35	$42.96
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $14.91 / $27.88 / $46.44	Professional	25	$14.91	$27.88	$46.44
Optum Facility/Professional Professional Modifier Low / Median / High Price $22.75 / $25.36 / $44.75	Professional		$22.75	$25.36	$44.75
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $21.30 / $21.30 / $21.30	Facility		$21.30	$21.30	$21.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $11.32 / $24.89 / $47.42	Professional		$11.32	$24.89	$47.42
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $11.66 / $135.00 / $190.00	Facility		$11.66	$135.00	$190.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $9.01 / $20.82 / $36.34	Professional		$9.01	$20.82	$36.34
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $8.61 / $22.22 / $28.30	Facility		$8.61	$22.22	$28.30
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $8.61 / $21.91 / $28.30	Professional		$8.61	$21.91	$28.30
United Facility/Professional Professional Modifier Low / Median / High Price $18.45 / $23.67 / $41.11	Professional		$18.45	$23.67	$41.11