Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.60 / $113.42 / $195.90	Facility		$103.60	$113.42	$195.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.60 / $152.71 / $340.01	Professional		$103.60	$152.71	$340.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.51 / $135.82 / $238.82	Professional		$114.51	$135.82	$238.82
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $139.82 / $149.80 / $245.13	Professional		$139.82	$149.80	$245.13
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $137.16 / $210.77 / $260.29	Professional		$137.16	$210.77	$260.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.03 / $149.03 / $149.03	Facility		$149.03	$149.03	$149.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.04 / $156.72 / $232.65	Professional		$117.04	$156.72	$232.65
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $82.62 / $148.41 / $249.66	Professional		$82.62	$148.41	$249.66
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,053.13 / $1,053.13 / $1,053.13	Facility		$1,053.13	$1,053.13	$1,053.13
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.01 / $139.88 / $209.73	Professional		$126.01	$139.88	$209.73
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $139.82 / $149.80 / $245.13	Professional		$139.82	$149.80	$245.13
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $103.60 / $106.34 / $195.90	Facility		$103.60	$106.34	$195.90
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $105.73 / $149.03 / $313.02	Professional		$105.73	$149.03	$313.02
Optum Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $138.50 / $168.58	Professional		$90.00	$138.50	$168.58
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $127.80 / $181.31 / $283.50	Professional		$127.80	$181.31	$283.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $149.03 / $149.03 / $149.03	Facility		$149.03	$149.03	$149.03
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $115.59 / $156.72 / $236.66	Professional		$115.59	$156.72	$236.66
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $127.43 / $127.43 / $131.88	Facility		$127.43	$127.43	$131.88
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $114.48 / $127.56 / $132.54	Professional		$114.48	$127.56	$132.54
United Facility/Professional Professional Modifier Low / Median / High Price $112.31 / $147.78 / $228.72	Professional		$112.31	$147.78	$228.72