Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3.72 / $8.51 / $181.97	Facility		$3.72	$8.51	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $91.20 / $199.53	Professional		$44.67	$91.20	$199.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $69.18 / $72.44	Professional		$47.86	$69.18	$72.44
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $8,511.38 / $8,511.38 / $77,624.71	Facility		$8,511.38	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $158.49	Professional		$77.62	$77.62	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $89.13 / $144.54	Professional		$60.26	$89.13	$144.54
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $109.65 / $165.96	Professional		$85.11	$109.65	$165.96
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $104.71 / $229.09	Professional		$77.62	$104.71	$229.09
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $4.27 / $8.51 / $181.97	Facility		$4.27	$8.51	$181.97
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $97.72 / $181.97	Professional		$42.66	$97.72	$181.97
Optum Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $83.18 / $112.20	Professional		$54.95	$83.18	$112.20
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $114.82 / $177.83	Facility		$93.33	$114.82	$177.83
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $97.72 / $204.17	Professional		$83.18	$97.72	$204.17
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $87.10 / $102.33	Facility		$25.70	$87.10	$102.33
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $27.54 / $69.18	Professional		$22.39	$27.54	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $85.11 / $134.90	Professional		$58.88	$85.11	$134.90