Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $22.91 / $47.86	Facility		$19.95	$22.91	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $30.90 / $100.00	Professional		$20.89	$30.90	$100.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $27.54 / $57.54 / $138.04	Professional	25	$27.54	$57.54	$138.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $30.20 / $56.23	Professional		$20.42	$30.20	$56.23
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 $25.70 / $30.20 / $48.98	Professional		$25.70	$30.20	$48.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $38.90	Facility		$38.90	$38.90	$38.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $35.48 / $60.26	Professional		$26.92	$35.48	$60.26
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $50.12 / $50.12	Facility		$50.12	$50.12	$50.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $46.77 / $64.57	Professional		$35.48	$46.77	$64.57
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $33.11 / $54.95	Professional		$28.18	$33.11	$54.95
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $30.20 / $38.90	Professional		$26.30	$30.20	$38.90
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $22.91 / $47.86	Facility		$19.95	$22.91	$47.86
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $32.36 / $69.18	Professional		$21.38	$32.36	$69.18
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $27.54 / $57.54 / $138.04	Professional	25	$27.54	$57.54	$138.04
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $34.67 / $58.88	Facility		$33.11	$34.67	$58.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $42.66 / $58.88	Professional		$33.11	$42.66	$58.88
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $28.84 / $33.11	Facility		$22.39	$28.84	$33.11
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $24.55 / $43.65	Professional		$14.79	$24.55	$43.65
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $30.90 / $48.98	Professional		$22.91	$30.90	$48.98