Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.14 / $107.60 / $197.34	Facility		$86.14	$107.60	$197.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.22 / $134.29 / $289.54	Professional		$80.22	$134.29	$289.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.00 / $131.56 / $176.96	Professional		$96.00	$131.56	$176.96
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $124.98 / $154.50 / $257.79	Professional		$124.98	$154.50	$257.79
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $8,459.92 / $8,639.91 / $79,506.39	Facility		$8,459.92	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $140.91 / $185.19 / $238.50	Professional		$140.91	$185.19	$238.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.60 / $125.60 / $125.60	Facility		$125.60	$125.60	$125.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.48 / $128.47 / $207.51	Professional		$86.48	$128.47	$207.51
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $203.97 / $203.97 / $203.97	Facility		$203.97	$203.97	$203.97
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $58.00 / $150.13 / $259.31	Professional		$58.00	$150.13	$259.31
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.56 / $103.63 / $157.28	Facility		$94.56	$103.63	$157.28
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.81 / $138.13 / $178.92	Professional		$116.81	$138.13	$178.92
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $128.77 / $155.94 / $257.79	Professional		$128.77	$155.94	$257.79
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $86.14 / $107.60 / $197.34	Facility		$86.14	$107.60	$197.34
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $88.06 / $148.51 / $277.16	Professional		$88.06	$148.51	$277.16
Optum Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $136.28 / $161.01	Professional		$105.00	$136.28	$161.01
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $113.00 / $123.66 / $123.66	Facility		$113.00	$123.66	$123.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $129.79 / $281.39	Professional		$105.00	$129.79	$281.39
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $119.18 / $125.60 / $125.60	Facility		$119.18	$125.60	$125.60
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $87.73 / $128.97 / $214.02	Professional		$87.73	$128.97	$214.02
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $108.13 / $108.13 / $127.34	Facility		$108.13	$108.13	$127.34
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $108.13 / $127.34 / $127.34	Professional		$108.13	$127.34	$127.34
United Facility/Professional Professional Modifier Low / Median / High Price $105.35 / $143.21 / $240.03	Professional		$105.35	$143.21	$240.03