Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.72 / $137.72 / $917.59	Facility		$137.72	$137.72	$917.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.47 / $137.72 / $139.34	Professional		$134.47	$137.72	$139.34
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $54.66 / $64.30 / $8,459.92	Facility		$54.66	$64.30	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $64.30 / $64.30 / $64.30	Professional		$64.30	$64.30	$64.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $137.72 / $137.72 / $137.72	Facility		$137.72	$137.72	$137.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.72 / $137.72 / $137.72	Professional		$137.72	$137.72	$137.72
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $137.66 / $137.66 / $137.66	Professional		$137.66	$137.66	$137.66
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $137.72 / $174.90 / $1,353.86	Facility		$137.72	$174.90	$1,353.86
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $132.86 / $137.72 / $355.32	Professional		$132.86	$137.72	$355.32
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $169.43 / $251.52 / $345.01	Professional		$169.43	$251.52	$345.01
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $137.72 / $137.72 / $137.72	Facility		$137.72	$137.72	$137.72
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $137.72 / $137.72 / $137.72	Professional		$137.72	$137.72	$137.72
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $153.91 / $153.91 / $169.31	Facility		$153.91	$153.91	$169.31
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $153.91 / $153.91 / $169.31	Professional		$153.91	$153.91	$169.31
United Facility/Professional Professional Modifier Low / Median / High Price $153.91 / $153.91 / $212.56	Professional		$153.91	$153.91	$212.56