Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.22 / $114.78 / $260.22	Facility		$26.22	$114.78	$260.22
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $95.19 / $150.38 / $251.29	Facility	25	$95.19	$150.38	$251.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.91 / $36.79 / $74.48	Professional		$23.91	$36.79	$74.48
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $41.27 / $74.81 / $144.00	Professional	25	$41.27	$74.81	$144.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.76 / $15.66 / $21.74	Professional	52	$11.76	$15.66	$21.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.28 / $37.47 / $46.98	Professional		$36.28	$37.47	$46.98
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $36.54 / $36.54 / $36.54	Professional	25	$36.54	$36.54	$36.54
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $8,459.92 / $8,639.91 / $79,506.39	Facility		$8,459.92	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $38.31 / $39.75 / $82.21	Professional		$38.31	$39.75	$82.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.77 / $35.77 / $35.77	Facility		$35.77	$35.77	$35.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $34.82 / $34.82	Professional		$34.82	$34.82	$34.82
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $59.68 / $59.68 / $59.68	Facility		$59.68	$59.68	$59.68
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.43 / $58.87 / $78.64	Professional		$45.43	$58.87	$78.64
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.04 / $262.14 / $412.72	Facility		$66.04	$262.14	$412.72
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.65 / $37.11 / $73.87	Professional		$32.65	$37.11	$73.87
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $35.68 / $37.86 / $74.05	Professional	25	$35.68	$37.86	$74.05
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $26.22 / $114.78 / $260.22	Facility		$26.22	$114.78	$260.22
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $95.19 / $150.38 / $251.29	Facility	25	$95.19	$150.38	$251.29
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $25.37 / $42.00 / $88.67	Professional		$25.37	$42.00	$88.67
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $41.27 / $56.54 / $144.00	Professional	25	$41.27	$56.54	$144.00
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $11.95 / $15.93 / $22.28	Professional	52	$11.95	$15.93	$22.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $40.57 / $78.90 / $112.00	Professional		$40.57	$78.90	$112.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $35.77 / $35.77 / $35.77	Facility		$35.77	$35.77	$35.77
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $34.82 / $34.82	Professional		$34.82	$34.82	$34.82
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $24.95 / $37.95 / $37.95	Facility		$24.95	$37.95	$37.95
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $26.04 / $31.02 / $40.46	Professional		$26.04	$31.02	$40.46
United Facility/Professional Professional Modifier Low / Median / High Price $30.99 / $41.56 / $75.86	Professional		$30.99	$41.56	$75.86