Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,825.00 / $8,950.50 / $9,868.50	Facility		$3,825.00	$8,950.50	$9,868.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,600.00 / $3,825.00 / $3,825.00	Professional		$3,600.00	$3,825.00	$3,825.00
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $3,633.75 / $4,275.00 / $8,459.92	Facility		$3,633.75	$4,275.00	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $4,275.00 / $4,275.00 / $4,275.00	Professional		$4,275.00	$4,275.00	$4,275.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,825.00 / $3,825.00 / $3,825.00	Facility		$3,825.00	$3,825.00	$3,825.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,825.00 / $3,825.00 / $3,825.00	Professional		$3,825.00	$3,825.00	$3,825.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $3,825.00 / $3,825.00 / $3,825.00	Professional		$3,825.00	$3,825.00	$3,825.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $3,825.00 / $5,737.50 / $9,868.50	Facility		$3,825.00	$5,737.50	$9,868.50
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $3,690.00 / $3,825.00 / $9,409.50	Professional		$3,690.00	$3,825.00	$9,409.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $3,825.00 / $3,825.00 / $3,825.00	Facility		$3,825.00	$3,825.00	$3,825.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $3,825.00 / $3,825.00 / $3,825.00	Professional		$3,825.00	$3,825.00	$3,825.00
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $4,275.00 / $4,275.00 / $4,702.50	Facility		$4,275.00	$4,275.00	$4,702.50
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $4,275.00 / $4,275.00 / $4,702.50	Professional		$4,275.00	$4,275.00	$4,702.50
United Facility/Professional Professional Modifier Low / Median / High Price $3,750.00 / $3,750.00 / $5,296.28	Professional		$3,750.00	$3,750.00	$5,296.28