Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $169.82 / $309.03	Facility		$81.28	$169.82	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $165.96 / $363.08	Professional		$91.20	$165.96	$363.08
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $128.82 / $169.82	Professional		$107.15	$128.82	$169.82
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 $144.54 / $151.36 / $223.87	Professional		$144.54	$151.36	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $151.36 / $151.36	Facility		$100.00	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $223.87	Professional		$91.20	$131.83	$223.87
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $158.49 / $275.42	Professional		$63.10	$158.49	$275.42
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $104.71 / $190.55	Professional		$89.13	$104.71	$190.55
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $77.62 / $81.28	Facility		$72.44	$77.62	$81.28
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $141.25 / $194.98	Professional		$123.03	$141.25	$194.98
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $239.88 / $239.88	Professional		$229.09	$239.88	$239.88
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $120.23 / $309.03	Facility		$81.28	$120.23	$309.03
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $144.54 / $288.40	Professional		$89.13	$144.54	$288.40
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $275.42	Facility		$100.00	$100.00	$275.42
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $120.23 / $316.23	Professional		$100.00	$120.23	$316.23
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $19.50 / $117.49 / $138.04	Facility		$19.50	$117.49	$138.04
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $114.82 / $138.04	Professional		$19.50	$114.82	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $125.89 / $199.53	Professional		$89.13	$125.89	$199.53