Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.38 / $124.15 / $301.60	Facility		$55.38	$124.15	$301.60
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $106.71 / $216.23 / $623.17	Facility	25	$106.71	$216.23	$623.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.81 / $83.73 / $180.48	Professional		$47.81	$83.73	$180.48
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $48.92 / $87.18 / $187.56	Professional	25	$48.92	$87.18	$187.56
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $254.64 / $262.68 / $271.76	Professional	50	$254.64	$262.68	$271.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.13 / $96.11 / $153.19	Professional		$62.13	$96.11	$153.19
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $74.87 / $92.85 / $153.19	Professional	25	$74.87	$92.85	$153.19
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $67.86 / $67.86 / $67.86	Facility		$67.86	$67.86	$67.86
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $65.51 / $88.00 / $131.13	Professional		$65.51	$88.00	$131.13
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 $95.78 / $110.48 / $129.97	Professional		$95.78	$110.48	$129.97
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $91.23 / $116.97 / $153.32	Professional	50	$91.23	$116.97	$153.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.08 / $147.00 / $194.00	Facility		$88.08	$147.00	$194.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $55.05 / $55.05 / $55.05	Facility	62	$55.05	$55.05	$55.05
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $8.81 / $8.81 / $8.81	Facility	AS	$8.81	$8.81	$8.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.56 / $80.77 / $132.00	Professional		$50.56	$80.77	$132.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $143.81 / $143.81 / $143.81	Facility		$143.81	$143.81	$143.81
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $46.16 / $114.67 / $163.13	Professional		$46.16	$114.67	$163.13
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.59 / $110.40 / $261.58	Facility		$73.59	$110.40	$261.58
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $135.29 / $186.50 / $219.60	Facility	25	$135.29	$186.50	$219.60
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.86 / $95.24 / $138.19	Professional		$61.86	$95.24	$138.19
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $68.37 / $94.02 / $127.08	Professional	25	$68.37	$94.02	$127.08
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $67.86 / $67.86 / $80.78	Facility		$67.86	$67.86	$80.78
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $68.06 / $91.26 / $134.27	Professional		$68.06	$91.26	$134.27
Johns Hopkins Employer Health Plan Facility/Professional Facility Modifier Low / Median / High Price $74.06 / $74.06 / $74.06	Facility		$74.06	$74.06	$74.06
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $74.06 / $74.06 / $108.28	Professional		$74.06	$74.06	$108.28
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $54.18 / $98.57 / $385.06	Facility		$54.18	$98.57	$385.06
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $101.40 / $253.57 / $690.53	Facility	25	$101.40	$253.57	$690.53
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $83.95 / $169.45	Professional		$52.75	$83.95	$169.45
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $49.77 / $86.60 / $184.08	Professional	25	$49.77	$86.60	$184.08
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $254.64 / $262.68 / $271.76	Professional	50	$254.64	$262.68	$271.76
Optum Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $90.82 / $112.05	Professional		$53.00	$90.82	$112.05
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $140.86 / $140.86 / $450.30	Facility		$140.86	$140.86	$450.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $53.40 / $99.42 / $182.21	Professional		$53.40	$99.42	$182.21
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $88.08 / $135.00 / $190.00	Facility		$88.08	$135.00	$190.00
Priority Health Facility/Professional Facility Modifier 62 Low / Median / High Price $55.05 / $55.05 / $55.05	Facility	62	$55.05	$55.05	$55.05
Priority Health Facility/Professional Facility Modifier AS Low / Median / High Price $8.81 / $8.81 / $8.81	Facility	AS	$8.81	$8.81	$8.81
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $50.53 / $82.27 / $132.00	Professional		$50.53	$82.27	$132.00
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $57.75 / $87.59 / $87.59	Facility		$57.75	$87.59	$87.59
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $62.74 / $81.00 / $92.55	Professional		$62.74	$81.00	$92.55
United Facility/Professional Professional Modifier Low / Median / High Price $56.68 / $81.08 / $145.35	Professional		$56.68	$81.08	$145.35