Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $60.26 / $194.98	Facility		$16.60	$60.26	$194.98
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $53.70 / $89.13 / $549.54	Facility	25	$53.70	$89.13	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $22.91 / $53.70	Professional		$7.94	$22.91	$53.70
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $16.98 / $31.62 / $69.18	Professional	25	$16.98	$31.62	$69.18
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $22.39 / $30.90	Professional		$8.32	$22.39	$30.90
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $18.20 / $21.88 / $26.30	Professional	25	$18.20	$21.88	$26.30
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $8,511.38 / $8,511.38 / $77,624.71	Facility		$8,511.38	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $33.88 / $46.77	Professional		$22.39	$33.88	$46.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $151.36 / $257.04	Facility		$27.54	$151.36	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $20.42 / $34.67	Professional		$8.71	$20.42	$34.67
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $16.98 / $16.98 / $16.98	Facility		$16.98	$16.98	$16.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.18 / $50.12	Professional		$21.88	$28.18	$50.12
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $18.62 / $18.62 / $22.39	Facility		$18.62	$18.62	$22.39
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $25.12 / $40.74	Professional		$18.62	$25.12	$40.74
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $93.33 / $151.36	Facility		$57.54	$93.33	$151.36
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $28.84 / $77.62 / $154.88	Facility	25	$28.84	$77.62	$154.88
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $25.12 / $34.67	Professional		$11.48	$25.12	$34.67
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $19.95 / $22.91 / $26.30	Professional	25	$19.95	$22.91	$26.30
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $8.91 / $8.91 / $8.91	Facility		$8.91	$8.91	$8.91
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $23.99 / $25.70	Professional		$22.39	$23.99	$25.70
Johns Hopkins Employer Health Plan Facility/Professional Facility Modifier Low / Median / High Price $13.18 / $13.18 / $13.18	Facility		$13.18	$13.18	$13.18
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $13.18 / $13.18 / $30.20	Professional		$13.18	$13.18	$30.20
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $8.32 / $53.70 / $229.09	Facility		$8.32	$53.70	$229.09
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $53.70 / $131.83 / $512.86	Facility	25	$53.70	$131.83	$512.86
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $7.59 / $20.42 / $43.65	Professional		$7.59	$20.42	$43.65
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $18.20 / $32.36 / $72.44	Professional	25	$18.20	$32.36	$72.44
Optum Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $25.70 / $41.69	Professional		$22.91	$25.70	$41.69
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $25.70 / $245.47	Facility		$21.38	$25.70	$245.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $36.31 / $47.86	Professional		$21.38	$36.31	$47.86
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $16.60 / $22.39 / $28.18	Facility		$16.60	$22.39	$28.18
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $6.92 / $16.60 / $44.67	Professional		$6.92	$16.60	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $18.62 / $32.36	Professional		$8.13	$18.62	$32.36