Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.68 / $61.80 / $82.40	Facility		$29.68	$61.80	$82.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.30 / $60.58 / $103.58	Professional		$30.30	$60.58	$103.58
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $41.76 / $100.08 / $152.41	Professional	25	$41.76	$100.08	$152.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.39 / $64.70 / $85.00	Professional		$40.39	$64.70	$85.00
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $46.13 / $46.13 / $49.19	Professional	25	$46.13	$46.13	$49.19
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $39.35 / $41.76 / $45.02	Professional		$39.35	$41.76	$45.02
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 $48.90 / $50.74 / $76.00	Professional		$48.90	$50.74	$76.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.54 / $56.54 / $56.54	Facility		$56.54	$56.54	$56.54
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $5.48 / $5.48 / $5.48	Facility	AS	$5.48	$5.48	$5.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.09 / $50.07 / $75.56	Professional		$36.09	$50.07	$75.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $55.78 / $93.66	Professional		$30.00	$55.78	$93.66
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $51.88 / $51.88 / $2,798.50	Facility		$51.88	$51.88	$2,798.50
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $3,981.65 / $3,981.65 / $3,981.65	Facility	25	$3,981.65	$3,981.65	$3,981.65
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.16 / $51.52 / $65.20	Professional		$45.16	$51.52	$65.20
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $45.09 / $48.76 / $76.62	Professional	25	$45.09	$48.76	$76.62
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $39.35 / $41.76 / $68.98	Professional		$39.35	$41.76	$68.98
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $29.68 / $35.88 / $82.40	Facility		$29.68	$35.88	$82.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $32.27 / $65.47 / $117.39	Professional		$32.27	$65.47	$117.39
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $37.88 / $83.30 / $149.00	Professional	25	$37.88	$83.30	$149.00
Optum Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $48.35 / $55.46	Professional		$43.00	$48.35	$55.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $66.50 / $92.26	Professional		$39.29	$66.50	$92.26
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $56.54 / $56.54 / $56.54	Facility		$56.54	$56.54	$56.54
Priority Health Facility/Professional Facility Modifier AS Low / Median / High Price $5.48 / $5.48 / $5.48	Facility	AS	$5.48	$5.48	$5.48
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $36.09 / $48.93 / $75.56	Professional		$36.09	$48.93	$75.56
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $45.87 / $48.66 / $48.66	Facility		$45.87	$48.66	$48.66
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $36.72 / $48.66 / $50.60	Professional		$36.72	$48.66	$50.60
United Facility/Professional Professional Modifier Low / Median / High Price $33.45 / $44.65 / $72.72	Professional		$33.45	$44.65	$72.72