Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $263.03 / $389.05	Facility		$112.20	$263.03	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $173.78 / $389.05	Professional		$112.20	$173.78	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $158.49 / $208.93	Professional		$128.82	$158.49	$208.93
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 $173.78 / $181.97 / $275.42	Professional		$173.78	$181.97	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $190.55 / $190.55	Facility		$107.15	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $275.42	Professional		$114.82	$162.18	$275.42
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Facility		$239.88	$239.88	$239.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $190.55 / $338.84	Professional		$85.11	$190.55	$338.84
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $131.83 / $229.09	Professional		$112.20	$131.83	$229.09
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $177.83 / $269.15	Professional		$144.54	$177.83	$269.15
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $165.96 / $331.13	Facility		$112.20	$165.96	$331.13
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $173.78 / $338.84	Professional		$112.20	$173.78	$338.84
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $120.23 / $331.13	Facility		$104.71	$120.23	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $389.05	Professional		$120.23	$120.23	$389.05
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $22.91 / $138.04 / $162.18	Facility		$22.91	$138.04	$162.18
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $138.04 / $524.81	Professional		$22.91	$138.04	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $154.88 / $245.47	Professional		$109.65	$154.88	$245.47