Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $149.71 / $217.56 / $426.81	Facility		$149.71	$217.56	$426.81
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $163.76 / $163.76 / $163.76	Facility	25	$163.76	$163.76	$163.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.72 / $220.22 / $450.00	Professional		$149.72	$220.22	$450.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $129.97 / $306.63 / $772.00	Professional	25	$129.97	$306.63	$772.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $412.58 / $412.58 / $425.99	Professional		$412.58	$412.58	$425.99
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $291.86 / $312.70 / $325.33	Professional		$291.86	$312.70	$325.33
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $85.10 / $8,459.92 / $79,506.39	Facility		$85.10	$8,459.92	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $277.41 / $300.83 / $438.90	Professional		$277.41	$300.83	$438.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.03 / $261.69 / $388.53	Professional		$178.03	$261.69	$388.53
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $428.12 / $428.12 / $428.12	Professional		$428.12	$428.12	$428.12
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $248.54 / $578.51 / $743.97	Facility		$248.54	$578.51	$743.97
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $291.86 / $303.64 / $325.33	Professional		$291.86	$303.64	$325.33
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $149.71 / $217.56 / $506.05	Facility		$149.71	$217.56	$506.05
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $163.76 / $163.76 / $163.76	Facility	25	$163.76	$163.76	$163.76
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $153.19 / $262.87 / $452.17	Professional		$153.19	$262.87	$452.17
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $150.27 / $351.57 / $497.33	Professional	25	$150.27	$351.57	$497.33
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $178.03 / $261.69 / $388.53	Professional		$178.03	$261.69	$388.53
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $177.56 / $186.38 / $267.95	Facility		$177.56	$186.38	$267.95
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $177.56 / $206.17 / $283.63	Professional		$177.56	$206.17	$283.63
United Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $287.88 / $468.98	Professional		$208.93	$287.88	$468.98