Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $154.88 / $338.84	Facility		$95.50	$154.88	$338.84
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $97.72 / $288.40 / $741.31	Facility	25	$97.72	$288.40	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $177.83 / $446.68	Professional		$95.50	$177.83	$446.68
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $102.33 / $199.53 / $478.63	Professional	25	$102.33	$199.53	$478.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $173.78 / $251.19	Professional		$123.03	$173.78	$251.19
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $144.54 / $181.97 / $251.19	Professional	25	$144.54	$181.97	$251.19
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 $48.98 / $199.53 / $263.03	Professional		$48.98	$199.53	$263.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $165.96 / $257.04	Facility		$120.23	$165.96	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $154.88 / $269.15	Professional		$109.65	$154.88	$269.15
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $223.87 / $389.05	Professional		$57.54	$223.87	$389.05
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $141.25	Facility		$117.49	$117.49	$141.25
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $199.53 / $316.23	Professional		$117.49	$199.53	$316.23
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $199.53 / $616.60	Facility		$75.86	$199.53	$616.60
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $104.71 / $245.47 / $331.13	Facility	25	$104.71	$245.47	$331.13
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $190.55 / $269.15	Professional		$144.54	$190.55	$269.15
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $144.54 / $177.83 / $245.47	Professional	25	$144.54	$177.83	$245.47
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $186.21 / $239.88	Professional		$173.78	$186.21	$239.88
Johns Hopkins Employer Health Plan Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Johns Hopkins Employer Health Plan Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $213.80	Professional		$162.18	$162.18	$213.80
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $147.91 / $323.59	Facility		$97.72	$147.91	$323.59
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $95.50 / $275.42 / $741.31	Facility	25	$95.50	$275.42	$741.31
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $162.18 / $338.84	Professional		$107.15	$162.18	$338.84
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $100.00 / $199.53 / $467.74	Professional	25	$100.00	$199.53	$467.74
Optum Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $165.96 / $218.78	Professional		$87.10	$165.96	$218.78
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $138.04 / $363.08	Facility		$123.03	$138.04	$363.08
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $257.04 / $363.08	Professional		$123.03	$257.04	$363.08
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $141.25 / $691.83	Facility		$38.90	$141.25	$691.83
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $81.28 / $190.55	Professional		$38.90	$81.28	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $138.04 / $229.09	Professional		$95.50	$138.04	$229.09