Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $74.13 / $446.68	Facility		$34.67	$74.13	$446.68
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $61.66 / $79.43 / $275.42	Facility	25	$61.66	$79.43	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $53.70 / $120.23	Professional		$29.51	$53.70	$120.23
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $32.36 / $58.88 / $125.89	Professional	25	$32.36	$58.88	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $53.70 / $79.43	Professional		$30.20	$53.70	$79.43
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $39.81 / $53.70 / $75.86	Professional	25	$39.81	$53.70	$75.86
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	50	$54.95	$54.95	$54.95
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 $54.95 / $61.66 / $72.44	Professional		$54.95	$61.66	$72.44
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $51.29 / $61.66 / $83.18	Professional	50	$51.29	$61.66	$83.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $151.36 / $257.04	Facility		$54.95	$151.36	$257.04
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $64.57 / $64.57 / $64.57	Facility	22	$64.57	$64.57	$64.57
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $33.88 / $33.88 / $33.88	Facility	62	$33.88	$33.88	$33.88
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $5.37 / $5.37 / $5.37	Facility	AS	$5.37	$5.37	$5.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $44.67 / $81.28	Professional		$26.92	$44.67	$81.28
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Facility		$69.18	$69.18	$69.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $69.18 / $123.03	Professional		$42.66	$69.18	$123.03
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $34.67 / $41.69	Facility		$34.67	$34.67	$41.69
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $60.26 / $97.72	Professional		$34.67	$60.26	$97.72
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $134.90 / $218.78	Facility		$43.65	$134.90	$218.78
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $83.18 / $131.83 / $194.98	Facility	25	$83.18	$131.83	$194.98
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $58.88 / $87.10	Professional		$36.31	$58.88	$87.10
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $36.31 / $56.23 / $83.18	Professional	25	$36.31	$56.23	$83.18
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $741.31	Facility		$36.31	$36.31	$741.31
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $58.88 / $67.61	Professional		$53.70	$58.88	$67.61
Johns Hopkins Employer Health Plan Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $36.31 / $36.31	Facility		$36.31	$36.31	$36.31
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $36.31 / $64.57	Professional		$36.31	$36.31	$64.57
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $63.10 / $389.05	Facility		$29.51	$63.10	$389.05
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $57.54 / $83.18 / $281.84	Facility	25	$57.54	$83.18	$281.84
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $47.86 / $97.72	Professional		$28.84	$47.86	$97.72
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $32.36 / $60.26 / $128.82	Professional	25	$32.36	$60.26	$128.82
Optum Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $53.70 / $74.13	Professional		$39.81	$53.70	$74.13
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $117.49 / $245.47	Facility		$38.02	$117.49	$245.47
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $77.62 / $114.82	Professional		$38.02	$77.62	$114.82
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $35.48 / $74.13	Facility		$23.99	$35.48	$74.13
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $36.31 / $69.18	Professional		$22.39	$36.31	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $39.81 / $67.61	Professional		$23.44	$39.81	$67.61