Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $13.58 / $39.15 / $67.64	Facility		$13.58	$39.15	$67.64
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $63.63 / $63.63 / $63.63	Facility	25	$63.63	$63.63	$63.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.56 / $14.69 / $31.29	Professional		$10.56	$14.69	$31.29
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $15.20 / $30.90 / $51.46	Professional	25	$15.20	$30.90	$51.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $12.33 / $14.50 / $22.12	Professional		$12.33	$14.50	$22.12
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $13.56 / $21.03 / $23.93	Professional	25	$13.56	$21.03	$23.93
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $15.74 / $17.41 / $28.49	Professional		$15.74	$17.41	$28.49
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 $14.27 / $14.81 / $26.83	Professional		$14.27	$14.81	$26.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.71 / $15.71 / $15.71	Facility		$15.71	$15.71	$15.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.34 / $15.38 / $25.26	Professional		$11.34	$15.38	$25.26
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $25.54 / $25.54 / $25.54	Facility		$25.54	$25.54	$25.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $16.52 / $21.06 / $29.21	Professional		$16.52	$21.06	$29.21
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $23.55 / $133.83 / $142.85	Facility		$23.55	$133.83	$142.85
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $13.60 / $16.27 / $24.17	Professional		$13.60	$16.27	$24.17
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $15.99 / $15.99 / $15.99	Professional	25	$15.99	$15.99	$15.99
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $15.66 / $17.41 / $28.49	Professional		$15.66	$17.41	$28.49
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $15.27 / $33.17 / $66.50	Facility		$15.27	$33.17	$66.50
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $63.63 / $63.63 / $63.63	Facility	25	$63.63	$63.63	$63.63
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $11.18 / $17.50 / $31.13	Professional		$11.18	$17.50	$31.13
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $19.30 / $30.29 / $51.88	Professional	25	$19.30	$30.29	$51.88
Optum Facility/Professional Professional Modifier Low / Median / High Price $20.60 / $20.60 / $20.60	Professional		$20.60	$20.60	$20.60
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $14.80 / $14.80 / $14.80	Facility		$14.80	$14.80	$14.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $14.80 / $17.67 / $29.80	Professional		$14.80	$17.67	$29.80
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $15.71 / $15.71 / $15.71	Facility		$15.71	$15.71	$15.71
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $15.53 / $26.31	Professional		$11.48	$15.53	$26.31
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $10.36 / $14.44 / $15.25	Facility		$10.36	$14.44	$15.25
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $11.26 / $14.09 / $15.18	Professional		$11.26	$14.09	$15.18
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $15.91 / $27.60	Professional		$12.30	$15.91	$27.60