Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.66 / $176.93 / $633.64	Facility		$151.66	$176.93	$633.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.41 / $208.44 / $464.91	Professional		$144.41	$208.44	$464.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $168.17 / $228.58 / $318.38	Professional		$168.17	$228.58	$318.38
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $205.63 / $220.32 / $360.51	Professional		$205.63	$220.32	$360.51
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 $160.97 / $189.39 / $367.59	Professional		$160.97	$189.39	$367.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $197.63 / $197.63 / $197.63	Facility		$197.63	$197.63	$197.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.37 / $220.41 / $340.87	Professional		$162.37	$220.41	$340.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $115.26 / $197.60 / $331.87	Professional		$115.26	$197.60	$331.87
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $193.90 / $193.90 / $193.90	Facility		$193.90	$193.90	$193.90
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $176.93 / $223.57 / $277.47	Professional		$176.93	$223.57	$277.47
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $205.63 / $220.32 / $360.51	Professional		$205.63	$220.32	$360.51
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $151.66 / $162.82 / $497.71	Facility		$151.66	$162.82	$497.71
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $149.72 / $210.25 / $443.72	Professional		$149.72	$210.25	$443.72
Optum Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $227.30 / $250.03	Professional		$105.00	$227.30	$250.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $173.84 / $250.03 / $416.70	Professional		$173.84	$250.03	$416.70
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $197.63 / $197.63 / $197.63	Facility		$197.63	$197.63	$197.63
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $162.37 / $220.38 / $341.74	Professional		$162.37	$220.38	$341.74
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $169.90 / $169.90 / $198.13	Facility		$169.90	$169.90	$198.13
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $149.04 / $169.90 / $198.13	Professional		$149.04	$169.90	$198.13
United Facility/Professional Professional Modifier Low / Median / High Price $163.95 / $216.53 / $355.80	Professional		$163.95	$216.53	$355.80