Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $174.00 / $301.33 / $1,644.50	Facility		$174.00	$301.33	$1,644.50
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,208.68 / $2,463.46 / $7,716.70	Facility	25	$1,208.68	$2,463.46	$7,716.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.23 / $239.45 / $573.05	Professional		$172.23	$239.45	$573.05
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $201.30 / $306.89 / $832.01	Professional	25	$201.30	$306.89	$832.01
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $201.30 / $310.55 / $544.23	Professional		$201.30	$310.55	$544.23
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $214.17 / $310.55 / $607.39	Professional	25	$214.17	$310.55	$607.39
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $214.06 / $243.28 / $418.33	Professional		$214.06	$243.28	$418.33
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,151.02 / $5,918.00 / $10,526.55	Facility		$5,151.02	$5,918.00	$10,526.55
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $272.19 / $385.74 / $503.72	Professional		$272.19	$385.74	$503.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $286.33 / $286.33 / $3,687.16	Facility		$286.33	$286.33	$3,687.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.23 / $284.58 / $483.61	Professional		$204.23	$284.58	$483.61
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $464.35 / $464.35 / $464.35	Facility		$464.35	$464.35	$464.35
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $316.02 / $418.59 / $776.63	Professional		$316.02	$418.59	$776.63
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,848.20 / $9,387.12 / $9,387.12	Facility		$2,848.20	$9,387.12	$9,387.12
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $881.20 / $2,345.39 / $12,695.85	Facility	25	$881.20	$2,345.39	$12,695.85
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.40 / $266.33 / $413.68	Professional		$239.40	$266.33	$413.68
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $237.34 / $278.29 / $417.18	Professional	25	$237.34	$278.29	$417.18
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $225.71 / $246.43 / $429.30	Professional		$225.71	$246.43	$429.30
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $180.15 / $392.89 / $1,644.50	Facility		$180.15	$392.89	$1,644.50
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $970.00 / $2,517.66 / $6,599.78	Facility	25	$970.00	$2,517.66	$6,599.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $178.93 / $269.74 / $535.64	Professional		$178.93	$269.74	$535.64
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $201.30 / $298.00 / $558.60	Professional	25	$201.30	$298.00	$558.60
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $227.90 / $2,114.86 / $2,114.86	Facility		$227.90	$2,114.86	$2,114.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $227.90 / $323.00 / $580.90	Professional		$227.90	$323.00	$580.90
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $286.33 / $286.33 / $3,687.16	Facility		$286.33	$286.33	$3,687.16
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $205.12 / $285.45 / $480.82	Professional		$205.12	$285.45	$480.82
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $209.33 / $260.11 / $280.43	Professional		$209.33	$260.11	$280.43
United Facility/Professional Facility Modifier Low / Median / High Price $2,041.11 / $2,041.11 / $2,267.90	Facility		$2,041.11	$2,041.11	$2,267.90
United Facility/Professional Professional Modifier Low / Median / High Price $226.92 / $301.02 / $513.11	Professional		$226.92	$301.02	$513.11