Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $371.54 / $776.25	Facility		$57.54	$371.54	$776.25
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $316.23 / $562.34 / $912.01	Facility	25	$316.23	$562.34	$912.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $57.54 / $128.82	Professional		$32.36	$57.54	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $56.23 / $67.61	Professional		$39.81	$56.23	$67.61
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $467.74 / $467.74 / $478.63	Facility		$467.74	$467.74	$478.63
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $43.65 / $57.54	Professional		$37.15	$43.65	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $1,318.26 / $3,235.94	Facility		$64.57	$1,318.26	$3,235.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $48.98 / $89.13	Professional		$34.67	$48.98	$89.13
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $67.61 / $120.23	Professional		$41.69	$67.61	$120.23
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $53.70 / $83.18	Professional		$34.67	$53.70	$83.18
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $380.19 / $446.68 / $758.58	Facility		$380.19	$446.68	$758.58
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $398.11 / $436.52 / $794.33	Facility	25	$398.11	$436.52	$794.33
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $54.95 / $69.18	Professional		$44.67	$54.95	$69.18
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,548.82 / $1,659.59	Facility		$1,548.82	$1,548.82	$1,659.59
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $181.97 / $245.47	Professional		$44.67	$181.97	$245.47
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $363.08 / $758.58	Facility		$50.12	$363.08	$758.58
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $316.23 / $537.03 / $891.25	Facility	25	$316.23	$537.03	$891.25
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $57.54 / $117.49	Professional		$33.11	$57.54	$117.49
Optum Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $43.65 / $109.65	Professional		$35.48	$43.65	$109.65
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $83.18 / $1,096.48	Facility		$39.81	$83.18	$1,096.48
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $70.79 / $87.10	Professional		$33.11	$70.79	$87.10
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $46.77 / $112.20	Professional		$35.48	$46.77	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $81.28	Professional		$34.67	$46.77	$81.28