Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $85.11 / $173.78	Facility		$77.62	$85.11	$173.78
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $891.25 / $891.25 / $891.25	Facility	25	$891.25	$891.25	$891.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $123.03 / $302.00	Professional		$79.43	$123.03	$302.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $114.82 / $165.96	Professional		$95.50	$114.82	$165.96
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,511.38 / $77,624.71	Facility		$5,011.87	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $169.82 / $204.17	Professional		$112.20	$169.82	$204.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Facility		$181.97	$181.97	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $125.89 / $194.98	Professional		$91.20	$125.89	$194.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $125.89 / $208.93	Professional		$52.48	$125.89	$208.93
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $107.15	Facility		$89.13	$89.13	$107.15
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $138.04 / $199.53	Professional		$85.11	$138.04	$199.53
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $120.23 / $181.97	Professional		$107.15	$120.23	$181.97
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $112.20 / $134.90	Professional		$107.15	$112.20	$134.90
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $83.18 / $147.91	Facility		$77.62	$83.18	$147.91
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $891.25 / $891.25 / $891.25	Facility	25	$891.25	$891.25	$891.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $117.49 / $257.04	Professional		$79.43	$117.49	$257.04
Optum Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $117.49 / $128.82	Professional		$72.44	$117.49	$128.82
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $199.53	Facility		$97.72	$97.72	$199.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $186.21 / $234.42	Professional		$89.13	$186.21	$234.42
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $27.54 / $27.54 / $117.49	Facility		$27.54	$27.54	$117.49
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $75.86 / $218.78	Professional		$27.54	$75.86	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $112.20 / $190.55	Professional		$83.18	$112.20	$190.55