Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.95 / $146.37 / $369.66	Facility		$74.95	$146.37	$369.66
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $111.00 / $195.21 / $424.02	Facility	25	$111.00	$195.21	$424.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.80 / $119.82 / $266.74	Professional		$60.80	$119.82	$266.74
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $61.93 / $125.70 / $286.60	Professional	25	$61.93	$125.70	$286.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.50 / $94.50 / $287.60	Professional	50	$94.50	$94.50	$287.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.06 / $141.49 / $201.48	Professional		$96.06	$141.49	$201.48
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $98.42 / $132.63 / $235.11	Professional	25	$98.42	$132.63	$235.11
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $100.02 / $100.02 / $626.23	Facility		$100.02	$100.02	$626.23
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $94.78 / $124.71 / $184.21	Professional		$94.78	$124.71	$184.21
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 $135.04 / $139.86 / $237.79	Professional		$135.04	$139.86	$237.79
Capital Blue Cross Facility/Professional Professional Modifier 50 Low / Median / High Price $133.79 / $173.39 / $216.60	Professional	50	$133.79	$173.39	$216.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $147.00 / $194.00	Facility		$125.00	$147.00	$194.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.13 / $119.75 / $188.57	Professional		$72.13	$119.75	$188.57
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $211.70 / $211.70 / $211.70	Facility		$211.70	$211.70	$211.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $46.16 / $169.44 / $251.33	Professional		$46.16	$169.44	$251.33
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.60 / $148.87 / $255.38	Facility		$91.60	$148.87	$255.38
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $69.34 / $183.86 / $243.20	Facility	25	$69.34	$183.86	$243.20
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.32 / $132.18 / $189.33	Professional		$85.32	$132.18	$189.33
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $107.20 / $136.94 / $187.40	Professional	25	$107.20	$136.94	$187.40
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $100.02 / $116.91 / $116.91	Facility		$100.02	$116.91	$116.91
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $98.29 / $125.60 / $189.86	Professional		$98.29	$125.60	$189.86
Johns Hopkins Employer Health Plan Facility/Professional Facility Modifier Low / Median / High Price $113.56 / $113.56 / $113.56	Facility		$113.56	$113.56	$113.56
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $113.56 / $113.56 / $158.97	Professional		$113.56	$113.56	$158.97
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $75.64 / $122.01 / $370.06	Facility		$75.64	$122.01	$370.06
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $94.54 / $217.25 / $712.65	Facility	25	$94.54	$217.25	$712.65
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $66.95 / $120.49 / $250.39	Professional		$66.95	$120.49	$250.39
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $61.29 / $124.06 / $265.95	Professional	25	$61.29	$124.06	$265.95
Martin's Point Facility/Professional Professional Modifier 50 Low / Median / High Price $94.50 / $94.50 / $287.60	Professional	50	$94.50	$94.50	$287.60
Optum Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $128.43 / $165.03	Professional		$70.00	$128.43	$165.03
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $169.21 / $169.21 / $444.60	Facility		$169.21	$169.21	$444.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $59.90 / $141.47 / $244.00	Professional		$59.90	$141.47	$244.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $135.00 / $190.00	Facility		$110.00	$135.00	$190.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $73.18 / $119.75 / $189.39	Professional		$73.18	$119.75	$189.39
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $81.93 / $124.06 / $124.06	Facility		$81.93	$124.06	$124.06
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $92.72 / $104.86 / $130.84	Professional		$92.72	$104.86	$130.84
United Facility/Professional Professional Modifier Low / Median / High Price $82.62 / $116.91 / $194.84	Professional		$82.62	$116.91	$194.84