Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.59 / $100.38 / $4,732.39	Facility		$80.59	$100.38	$4,732.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.45 / $116.31 / $312.58	Professional		$80.45	$116.31	$312.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.62 / $163.00 / $209.86	Professional		$107.62	$163.00	$209.86
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $109.51 / $117.18 / $191.99	Professional		$109.51	$117.18	$191.99
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 $114.08 / $165.35 / $215.60	Professional		$114.08	$165.35	$215.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.88 / $129.88 / $129.88	Facility		$129.88	$129.88	$129.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.86 / $129.02 / $194.66	Professional		$94.86	$129.02	$194.66
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $114.34 / $166.35 / $312.52	Professional		$114.34	$166.35	$312.52
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.35 / $113.35 / $113.35	Facility		$113.35	$113.35	$113.35
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.65 / $120.65 / $181.62	Professional		$110.65	$120.65	$181.62
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $109.51 / $117.33 / $212.20	Professional		$109.51	$117.33	$212.20
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $80.59 / $86.17 / $668.43	Facility		$80.59	$86.17	$668.43
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $82.07 / $118.09 / $252.28	Professional		$82.07	$118.09	$252.28
Optum Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $120.78 / $132.86	Professional		$95.00	$120.78	$132.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $99.70 / $161.43 / $222.30	Professional		$99.70	$161.43	$222.30
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $129.88 / $129.88 / $129.88	Facility		$129.88	$129.88	$129.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $94.00 / $127.30 / $195.66	Professional		$94.00	$127.30	$195.66
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $106.57 / $111.91 / $111.91	Facility		$106.57	$111.91	$111.91
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $86.40 / $111.91 / $116.78	Professional		$86.40	$111.91	$116.78
United Facility/Professional Professional Modifier Low / Median / High Price $90.56 / $120.22 / $196.94	Professional		$90.56	$120.22	$196.94