Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.14 / $278.19 / $1,414.40	Facility		$98.14	$278.19	$1,414.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.48 / $116.95 / $745.60	Professional		$102.48	$116.95	$745.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $160.00 / $160.00 / $266.80	Professional		$160.00	$160.00	$266.80
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $108.89 / $127.95 / $2,674.15	Facility		$108.89	$127.95	$2,674.15
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $62.27 / $62.27 / $62.27	Professional		$62.27	$62.27	$62.27
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $363.84 / $428.05 / $8,459.92	Facility		$363.84	$428.05	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $428.05 / $428.05 / $428.05	Professional		$428.05	$428.05	$428.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.99 / $109.99 / $109.99	Facility		$109.99	$109.99	$109.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.99 / $109.99 / $109.99	Professional		$109.99	$109.99	$109.99
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $114.47 / $134.66 / $134.66	Professional		$114.47	$134.66	$134.66
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $62.80 / $345.87 / $847.28	Facility		$62.80	$345.87	$847.28
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $134.66	Professional		$75.00	$75.00	$134.66
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $108.89 / $124.27 / $2,567.50	Facility		$108.89	$124.27	$2,567.50
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $62.27 / $62.27 / $62.27	Professional		$62.27	$62.27	$62.27
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $108.89 / $482.17 / $1,414.40	Facility		$108.89	$482.17	$1,414.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $102.48 / $148.84 / $710.40	Professional		$102.48	$148.84	$710.40
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,051.89 / $2,109.21 / $2,733.45	Facility		$2,051.89	$2,109.21	$2,733.45
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $245.07 / $363.89 / $499.24	Professional		$245.07	$363.89	$499.24
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $109.99 / $109.99 / $109.99	Facility		$109.99	$109.99	$109.99
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $109.99 / $109.99 / $109.99	Professional		$109.99	$109.99	$109.99
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $121.70 / $121.70 / $121.70	Facility		$121.70	$121.70	$121.70
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $116.28 / $121.70 / $121.70	Professional		$116.28	$121.70	$121.70
United Facility/Professional Professional Modifier Low / Median / High Price $450.58 / $450.58 / $636.37	Professional		$450.58	$450.58	$636.37