Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.88 / $66.59 / $124.17	Facility		$60.88	$66.59	$124.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.00 / $73.33 / $132.53	Professional		$53.00	$73.33	$132.53
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $60.83 / $78.51 / $245.60	Professional	25	$60.83	$78.51	$245.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.70 / $77.30 / $124.23	Professional		$70.70	$77.30	$124.23
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $71.09 / $77.83 / $100.00	Professional	25	$71.09	$77.83	$100.00
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $88.37 / $93.73 / $113.01	Professional		$88.37	$93.73	$113.01
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 $81.94 / $85.03 / $156.40	Professional		$81.94	$85.03	$156.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.27 / $100.27 / $100.27	Facility		$100.27	$100.27	$100.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.70 / $95.45 / $151.66	Professional		$65.70	$95.45	$151.66
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $163.28 / $163.28 / $163.28	Facility		$163.28	$163.28	$163.28
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $93.94 / $119.97 / $167.72	Professional		$93.94	$119.97	$167.72
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.93 / $83.95 / $130.80	Professional		$73.93	$83.95	$130.80
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $75.26 / $81.62 / $103.35	Professional	25	$75.26	$81.62	$103.35
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $88.37 / $93.73 / $116.57	Professional		$88.37	$93.73	$116.57
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $60.88 / $66.59 / $124.17	Facility		$60.88	$66.59	$124.17
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $60.88 / $82.93 / $146.57	Professional		$60.88	$82.93	$146.57
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $62.75 / $78.51 / $266.29	Professional	25	$62.75	$78.51	$266.29
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.48 / $104.64 / $169.30	Professional		$83.48	$104.64	$169.30
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $100.27 / $100.27 / $100.27	Facility		$100.27	$100.27	$100.27
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $69.27 / $94.30 / $153.38	Professional		$69.27	$94.30	$153.38
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $80.78 / $80.78 / $85.70	Facility		$80.78	$80.78	$85.70
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $80.70 / $85.70	Professional		$73.81	$80.70	$85.70
United Facility/Professional Professional Modifier Low / Median / High Price $73.93 / $93.48 / $159.13	Professional		$73.93	$93.48	$159.13
United Facility/Professional Professional Modifier 25 Low / Median / High Price $98.97 / $99.10 / $99.10	Professional	25	$98.97	$99.10	$99.10