Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,100.00 / $5,100.00 / $6,477.00	Facility		$5,100.00	$5,100.00	$6,477.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $4,800.00 / $5,100.00 / $5,100.00	Professional		$4,800.00	$5,100.00	$5,100.00
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $4,602.75 / $5,415.00 / $8,639.91	Facility		$4,602.75	$5,415.00	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $5,700.00 / $5,700.00 / $5,700.00	Professional		$5,700.00	$5,700.00	$5,700.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,100.00 / $5,100.00 / $5,100.00	Facility		$5,100.00	$5,100.00	$5,100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $5,100.00 / $5,100.00 / $5,100.00	Professional		$5,100.00	$5,100.00	$5,100.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $5,100.00 / $5,100.00 / $5,100.00	Professional		$5,100.00	$5,100.00	$5,100.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $5,100.00 / $6,477.00 / $7,293.00	Facility		$5,100.00	$6,477.00	$7,293.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $4,800.00 / $5,100.00 / $5,100.00	Professional		$4,800.00	$5,100.00	$5,100.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $148.00 / $148.00 / $178.30	Professional		$148.00	$148.00	$178.30
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $5,100.00 / $5,100.00 / $5,100.00	Facility		$5,100.00	$5,100.00	$5,100.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $5,100.00 / $5,100.00 / $5,100.00	Professional		$5,100.00	$5,100.00	$5,100.00
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $5,700.00 / $5,700.00 / $6,270.00	Facility		$5,700.00	$5,700.00	$6,270.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $5,700.00 / $5,700.00 / $6,270.00	Professional		$5,700.00	$5,700.00	$6,270.00
United Facility/Professional Professional Modifier Low / Median / High Price $5,000.00 / $5,000.00 / $6,250.00	Professional		$5,000.00	$5,000.00	$6,250.00