Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $89.49 / $176.09	Facility		$75.00	$89.49	$176.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.16 / $127.00 / $276.36	Professional		$79.16	$127.00	$276.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.13 / $131.18 / $186.59	Professional		$99.13	$131.18	$186.59
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $141.38 / $141.38 / $141.38	Professional		$141.38	$141.38	$141.38
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 $135.28 / $177.19 / $229.71	Professional		$135.28	$177.19	$229.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $124.66 / $124.66 / $124.66	Facility		$124.66	$124.66	$124.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.08 / $125.20 / $204.32	Professional		$87.08	$125.20	$204.32
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $202.55 / $202.55 / $202.55	Facility		$202.55	$202.55	$202.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $157.99 / $244.76	Professional		$61.00	$157.99	$244.76
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $13.00 / $48.41 / $124.35	Facility		$13.00	$48.41	$124.35
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.37 / $130.93 / $159.63	Professional		$107.37	$130.93	$159.63
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $141.38 / $141.38 / $141.38	Professional		$141.38	$141.38	$141.38
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $85.23 / $176.09	Facility		$75.00	$85.23	$176.09
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $85.23 / $138.19 / $264.36	Professional		$85.23	$138.19	$264.36
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $101.09 / $101.09 / $448.00	Facility		$101.09	$101.09	$448.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $116.62 / $130.00 / $268.39	Professional		$116.62	$130.00	$268.39
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $107.45 / $124.66 / $124.66	Facility		$107.45	$124.66	$124.66
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $88.56 / $126.31 / $206.83	Professional		$88.56	$126.31	$206.83
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $103.83 / $103.83 / $122.18	Facility		$103.83	$103.83	$122.18
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $103.83 / $122.18 / $122.18	Professional		$103.83	$122.18	$122.18
United Facility/Professional Professional Modifier Low / Median / High Price $100.23 / $137.41 / $236.30	Professional		$100.23	$137.41	$236.30