Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $100.00 / $213.80	Facility		$97.72	$100.00	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $125.89 / $263.03	Professional		$95.50	$125.89	$263.03
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $147.91 / $147.91 / $147.91	Professional	25	$147.91	$147.91	$147.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $123.03 / $162.18	Professional		$102.33	$123.03	$162.18
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $114.82 / $117.49 / $131.83	Professional	25	$114.82	$117.49	$131.83
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,511.38 / $77,624.71	Facility		$5,011.87	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $128.82 / $234.42	Professional		$109.65	$128.82	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $128.82 / $204.17	Professional		$87.10	$128.82	$204.17
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $204.17 / $234.42	Professional		$144.54	$204.17	$234.42
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $100.00 / $186.21	Facility		$97.72	$100.00	$186.21
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $128.82 / $263.03	Professional		$100.00	$128.82	$263.03
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $147.91 / $147.91 / $147.91	Professional	25	$147.91	$147.91	$147.91
Optum Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $162.18	Professional		$104.71	$144.54	$162.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $144.54 / $162.18	Professional		$104.71	$144.54	$162.18
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $117.49 / $128.82	Facility		$22.39	$117.49	$128.82
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $117.49 / $309.03	Professional		$22.39	$117.49	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $144.54 / $239.88	Professional		$109.65	$144.54	$239.88