Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $110.63 / $161.43 / $314.89	Facility		$110.63	$161.43	$314.89
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $169.65 / $506.05 / $565.48	Facility	25	$169.65	$506.05	$565.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $110.07 / $164.10 / $340.60	Professional		$110.07	$164.10	$340.60
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $149.58 / $265.70 / $567.00	Professional	25	$149.58	$265.70	$567.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $178.44 / $178.44 / $304.39	Professional		$178.44	$178.44	$304.39
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $185.00 / $185.00 / $314.24	Professional	25	$185.00	$185.00	$314.24
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $215.59 / $230.99 / $340.18	Professional		$215.59	$230.99	$340.18
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $204.64 / $221.93 / $323.89	Professional		$204.64	$221.93	$323.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.06 / $187.17 / $286.73	Professional		$131.06	$187.17	$286.73
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $315.75 / $315.75 / $315.75	Professional		$315.75	$315.75	$315.75
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $248.54 / $365.00 / $743.97	Facility		$248.54	$365.00	$743.97
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $333.57 / $520.78 / $578.51	Facility	25	$333.57	$520.78	$578.51
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $209.93 / $224.30 / $323.97	Professional		$209.93	$224.30	$323.97
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $110.63 / $161.43 / $314.89	Facility		$110.63	$161.43	$314.89
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $169.65 / $516.41 / $565.48	Facility	25	$169.65	$516.41	$565.48
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $113.00 / $189.53 / $347.90	Professional		$113.00	$189.53	$347.90
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $144.97 / $265.70 / $421.27	Professional	25	$144.97	$265.70	$421.27
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $131.06 / $192.42 / $286.73	Professional		$131.06	$192.42	$286.73
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $121.14 / $136.72 / $197.74	Facility		$121.14	$136.72	$197.74
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $121.14 / $145.97 / $209.36	Professional		$121.14	$145.97	$209.36
United Facility/Professional Professional Modifier Low / Median / High Price $152.94 / $208.52 / $335.44	Professional		$152.94	$208.52	$335.44