Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.14 / $272.70 / $713.13	Facility		$106.14	$272.70	$713.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $272.70 / $292.93	Professional		$141.60	$272.70	$292.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $192.50 / $192.50 / $192.50	Professional		$192.50	$192.50	$192.50
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $272.70 / $546.46 / $1,170.00	Facility		$272.70	$546.46	$1,170.00
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $606.76 / $713.83 / $8,459.92	Facility		$606.76	$713.83	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $713.83 / $713.83 / $713.83	Professional		$713.83	$713.83	$713.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $272.70 / $272.70 / $272.70	Facility		$272.70	$272.70	$272.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.70 / $272.70 / $272.70	Professional		$272.70	$272.70	$272.70
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $54.54 / $54.54 / $54.54	Professional		$54.54	$54.54	$54.54
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.60 / $304.80 / $541.09	Facility		$117.60	$304.80	$541.09
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $272.70 / $272.70 / $272.70	Professional		$272.70	$272.70	$272.70
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $272.70 / $320.43 / $1,123.33	Facility		$272.70	$320.43	$1,123.33
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $108.91 / $295.87 / $713.13	Facility		$108.91	$295.87	$713.13
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $272.70 / $346.34	Professional		$141.60	$272.70	$346.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $249.98 / $371.08 / $508.97	Professional		$249.98	$371.08	$508.97
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $272.70 / $272.70 / $272.70	Facility		$272.70	$272.70	$272.70
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $272.70 / $272.70 / $272.70	Professional		$272.70	$272.70	$272.70
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $304.80 / $304.80 / $335.28	Facility		$304.80	$304.80	$335.28
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $304.80 / $304.80 / $713.83	Professional		$304.80	$304.80	$713.83
United Facility/Professional Professional Modifier Low / Median / High Price $267.37 / $267.37 / $489.29	Professional		$267.37	$267.37	$489.29