Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.37 / $143.66 / $237.35	Facility		$87.37	$143.66	$237.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.55 / $97.58 / $146.47	Professional		$81.55	$97.58	$146.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.50 / $101.50 / $117.70	Professional		$101.50	$101.50	$117.70
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $111.41 / $111.41 / $114.32	Professional		$111.41	$111.41	$114.32
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 $109.76 / $113.90 / $204.53	Professional		$109.76	$113.90	$204.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.81 / $127.81 / $127.81	Facility		$127.81	$127.81	$127.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.30 / $124.89 / $195.29	Professional		$89.30	$124.89	$195.29
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $207.61 / $207.61 / $207.61	Facility		$207.61	$207.61	$207.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $126.16 / $162.19 / $224.81	Professional		$126.16	$162.19	$224.81
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.94 / $132.18 / $134.72	Professional		$129.94	$132.18	$134.72
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $96.88 / $111.41 / $114.32	Professional		$96.88	$111.41	$114.32
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $87.37 / $100.24 / $245.75	Facility		$87.37	$100.24	$245.75
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $85.82 / $111.81 / $266.00	Professional		$85.82	$111.81	$266.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $136.19 / $136.19 / $136.19	Facility		$136.19	$136.19	$136.19
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $103.55 / $136.19 / $231.90	Professional		$103.55	$136.19	$231.90
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $124.96 / $127.81 / $127.81	Facility		$124.96	$127.81	$127.81
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $89.34 / $124.62 / $198.40	Professional		$89.34	$124.62	$198.40
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $107.93 / $133.09 / $138.44	Facility		$107.93	$133.09	$138.44
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $133.09 / $133.09 / $137.08	Professional		$133.09	$133.09	$137.08
United Facility/Professional Professional Modifier Low / Median / High Price $99.20 / $128.19 / $208.62	Professional		$99.20	$128.19	$208.62