Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $186.21 / $1,479.11	Facility		$83.18	$186.21	$1,479.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $97.72 / $363.08	Professional		$75.86	$97.72	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $87.10 / $93.33	Professional		$83.18	$87.10	$93.33
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 $89.13 / $134.90 / $204.17	Professional		$89.13	$134.90	$204.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $134.90	Facility		$134.90	$134.90	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $117.49 / $181.97	Professional		$83.18	$117.49	$181.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $151.36 / $275.42	Professional		$93.33	$151.36	$275.42
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $199.53	Professional		$97.72	$125.89	$199.53
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $186.21 / $1,479.11	Facility		$83.18	$186.21	$1,479.11
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.82 / $309.03	Professional		$79.43	$114.82	$309.03
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $218.78	Facility		$104.71	$104.71	$218.78
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $204.17 / $245.47	Professional		$63.10	$204.17	$245.47
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $70.79 / $123.03	Facility		$67.61	$70.79	$123.03
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $79.43 / $112.20	Professional		$67.61	$79.43	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $114.82 / $190.55	Professional		$83.18	$114.82	$190.55