Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $141.25 / $302.00	Facility		$89.13	$141.25	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $190.55 / $467.74	Professional		$109.65	$190.55	$467.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $147.91 / $194.98	Professional		$114.82	$147.91	$194.98
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $8,511.38 / $8,511.38 / $77,624.71	Facility		$8,511.38	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $169.82 / $251.19	Professional		$162.18	$169.82	$251.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $173.78 / $173.78	Facility		$97.72	$173.78	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $151.36 / $257.04	Professional		$102.33	$151.36	$257.04
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $162.18 / $309.03	Professional		$67.61	$162.18	$309.03
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $120.23 / $213.80	Professional		$102.33	$120.23	$213.80
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $218.78 / $218.78	Facility		$95.50	$218.78	$218.78
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $158.49 / $213.80	Professional		$131.83	$158.49	$213.80
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $281.84 / $281.84	Professional		$257.04	$281.84	$281.84
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $104.71 / $302.00	Facility		$85.11	$104.71	$302.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $165.96 / $331.13	Professional		$104.71	$165.96	$331.13
Optum Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $162.18 / $186.21	Professional		$104.71	$162.18	$186.21
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $218.78 / $309.03	Facility		$123.03	$218.78	$309.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $147.91 / $354.81	Professional		$123.03	$147.91	$354.81
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $125.89 / $151.36	Facility		$30.20	$125.89	$151.36
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $125.89 / $151.36	Professional		$30.20	$125.89	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $144.54 / $223.87	Professional		$102.33	$144.54	$223.87