Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $87.10 / $138.04	Professional		$70.79	$87.10	$138.04
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,511.38 / $77,624.71	Facility		$5,011.87	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $12.59 / $112.20 / $125.89	Professional		$12.59	$112.20	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $158.49	Professional		$81.28	$81.28	$158.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $97.72 / $128.82	Professional		$77.62	$97.72	$128.82
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $89.13 / $138.04	Professional		$75.86	$89.13	$138.04
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $141.25 / $141.25	Facility		$138.04	$141.25	$141.25
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $138.04 / $141.25	Professional		$66.07	$138.04	$141.25
United Facility/Professional Facility Modifier Low / Median / High Price $8.13 / $67.61 / $112.20	Facility		$8.13	$67.61	$112.20
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $91.20 / $165.96	Professional		$70.79	$91.20	$165.96