Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.53 / $357.24 / $651.94	Facility		$57.53	$357.24	$651.94
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $313.87 / $539.74 / $820.50	Facility	25	$313.87	$539.74	$820.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.10 / $49.75 / $90.08	Professional		$31.10	$49.75	$90.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.67 / $61.05 / $95.78	Professional		$39.67	$61.05	$95.78
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $1,561.00 / $1,561.00 / $1,647.00	Facility		$1,561.00	$1,561.00	$1,647.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $47.06 / $184.50 / $259.39	Professional		$47.06	$184.50	$259.39
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $414.90 / $473.00 / $662.00	Facility		$414.90	$473.00	$662.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $37.09 / $43.64 / $62.05	Professional		$37.09	$43.64	$62.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.16 / $1,313.00 / $3,255.00	Facility		$48.16	$1,313.00	$3,255.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.96 / $49.88 / $84.43	Professional		$34.96	$49.88	$84.43
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $91.22 / $91.22 / $91.22	Facility		$91.22	$91.22	$91.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $47.78 / $68.31 / $118.30	Professional		$47.78	$68.31	$118.30
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $399.37 / $428.45 / $763.19	Facility		$399.37	$428.45	$763.19
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $399.37 / $428.45 / $539.29	Facility	25	$399.37	$428.45	$539.29
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.25 / $55.11 / $68.34	Professional		$45.25	$55.11	$68.34
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,561.00 / $1,561.00 / $1,647.00	Facility		$1,561.00	$1,561.00	$1,647.00
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $47.06 / $175.66 / $247.13	Professional		$47.06	$175.66	$247.13
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $52.66 / $350.12 / $754.00	Facility		$52.66	$350.12	$754.00
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $313.87 / $513.15 / $893.96	Facility	25	$313.87	$513.15	$893.96
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $33.72 / $59.00 / $103.38	Professional		$33.72	$59.00	$103.38
Optum Facility/Professional Professional Modifier Low / Median / High Price $42.02 / $44.12 / $110.00	Professional		$42.02	$44.12	$110.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,087.95 / $1,087.95 / $1,087.95	Facility		$1,087.95	$1,087.95	$1,087.95
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.20 / $62.31 / $103.00	Professional		$33.20	$62.31	$103.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $48.16 / $1,250.00 / $3,100.00	Facility		$48.16	$1,250.00	$3,100.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $35.33 / $49.93 / $84.16	Professional		$35.33	$49.93	$84.16
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $41.61 / $42.63	Professional		$39.81	$41.61	$42.63
United Facility/Professional Professional Modifier Low / Median / High Price $35.51 / $46.67 / $81.99	Professional		$35.51	$46.67	$81.99