Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.48 / $718.76 / $1,183.34	Facility		$74.48	$718.76	$1,183.34
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $329.26 / $779.50 / $1,438.48	Facility	25	$329.26	$779.50	$1,438.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.64 / $66.00 / $145.88	Professional		$50.64	$66.00	$145.88
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $65.70 / $110.50 / $174.62	Professional	25	$65.70	$110.50	$174.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.41 / $102.96 / $209.82	Professional		$66.41	$102.96	$209.82
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $67.04 / $102.96 / $248.81	Professional	25	$67.04	$102.96	$248.81
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $74.70 / $105.57 / $261.24	Professional		$74.70	$105.57	$261.24
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $877.43 / $958.00 / $1,310.00	Facility		$877.43	$958.00	$1,310.00
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $71.06 / $73.73 / $139.61	Professional		$71.06	$73.73	$139.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.02 / $1,539.00 / $3,255.00	Facility		$82.02	$1,539.00	$3,255.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.54 / $81.31 / $140.72	Professional		$59.54	$81.31	$140.72
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $153.76 / $153.76 / $153.76	Facility		$153.76	$153.76	$153.76
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $80.54 / $125.29 / $198.83	Professional		$80.54	$125.29	$198.83
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $668.36 / $720.36 / $935.95	Facility		$668.36	$720.36	$935.95
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $698.28 / $749.15 / $942.96	Facility	25	$698.28	$749.15	$942.96
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $94.07 / $127.28	Professional		$81.59	$94.07	$127.28
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $76.69 / $106.97 / $343.66	Professional	25	$76.69	$106.97	$343.66
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $770.00 / $770.00 / $770.00	Facility		$770.00	$770.00	$770.00
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $74.70 / $122.00 / $247.13	Professional		$74.70	$122.00	$247.13
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $74.48 / $681.81 / $1,183.34	Facility		$74.48	$681.81	$1,183.34
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $122.94 / $740.96 / $1,452.02	Facility	25	$122.94	$740.96	$1,452.02
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $53.02 / $74.28 / $150.90	Professional		$53.02	$74.28	$150.90
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $57.30 / $105.73 / $158.91	Professional	25	$57.30	$105.73	$158.91
Optum Facility/Professional Professional Modifier Low / Median / High Price $64.80 / $72.18 / $165.00	Professional		$64.80	$72.18	$165.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $66.90 / $102.50 / $165.00	Professional		$66.90	$102.50	$165.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $82.02 / $1,250.00 / $3,100.00	Facility		$82.02	$1,250.00	$3,100.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $60.49 / $83.19 / $137.71	Professional		$60.49	$83.19	$137.71
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $68.33 / $71.52 / $73.23	Professional		$68.33	$71.52	$73.23
United Facility/Professional Professional Modifier Low / Median / High Price $56.44 / $75.39 / $123.23	Professional		$56.44	$75.39	$123.23