Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $2,454.71 / $5,754.40	Facility		$602.56	$2,454.71	$5,754.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $436.52 / $2,511.89 / $3,162.28	Facility	52	$436.52	$2,511.89	$3,162.28
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $83.18 / $154.88 / $331.13	Facility	53	$83.18	$154.88	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $316.23 / $851.14	Professional		$173.78	$316.23	$851.14
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $67.61 / $128.82 / $263.03	Professional	53	$67.61	$128.82	$263.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $181.97 / $323.59	Professional		$169.82	$181.97	$323.59
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $85.11 / $144.54 / $165.96	Professional	53	$85.11	$144.54	$165.96
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $2,691.53 / $57,543.99	Facility		$2,630.27	$2,691.53	$57,543.99
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $363.08 / $575.44	Professional		$309.03	$363.08	$575.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $724.44 / $1,380.38	Facility		$371.54	$724.44	$1,380.38
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	22	$446.68	$446.68	$446.68
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $295.12 / $295.12 / $295.12	Facility	52	$295.12	$295.12	$295.12
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	53	$74.13	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Professional		$302.00	$302.00	$302.00
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $41.69 / $89.13 / $162.18	Professional	53	$41.69	$89.13	$162.18
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $371.54 / $371.54	Facility		$371.54	$371.54	$371.54
Emblem Health Facility/Professional Facility Modifier 53 Low / Median / High Price $186.21 / $186.21 / $186.21	Facility	53	$186.21	$186.21	$186.21
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $549.54 / $776.25	Professional		$398.11	$549.54	$776.25
Emblem Health Facility/Professional Professional Modifier 53 Low / Median / High Price $199.53 / $269.15 / $389.05	Professional	53	$199.53	$269.15	$389.05
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $407.38 / $630.96	Professional		$223.87	$407.38	$630.96
Geisinger Facility/Professional Professional Modifier 53 Low / Median / High Price $63.10 / $177.83 / $302.00	Professional	53	$63.10	$177.83	$302.00
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $1,819.70 / $3,311.31	Facility		$831.76	$1,819.70	$3,311.31
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $912.01 / $1,174.90 / $1,288.25	Facility	52	$912.01	$1,174.90	$1,288.25
Highmark BCBS Facility/Professional Facility Modifier 53 Low / Median / High Price $2,754.23 / $2,754.23 / $3,090.30	Facility	53	$2,754.23	$2,754.23	$3,090.30
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $239.88 / $338.84	Professional		$208.93	$239.88	$338.84
Highmark BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $204.17 / $269.15 / $338.84	Professional	53	$204.17	$269.15	$338.84
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $7,585.78 / $7,585.78 / $7,585.78	Facility		$7,585.78	$7,585.78	$7,585.78
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $2,187.76 / $5,754.40	Facility		$575.44	$2,187.76	$5,754.40
Martin's Point Facility/Professional Facility Modifier 52 Low / Median / High Price $436.52 / $2,511.89 / $3,162.28	Facility	52	$436.52	$2,511.89	$3,162.28
Martin's Point Facility/Professional Facility Modifier 53 Low / Median / High Price $83.18 / $154.88 / $302.00	Facility	53	$83.18	$154.88	$302.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $338.84 / $851.14	Professional		$173.78	$338.84	$851.14
Martin's Point Facility/Professional Professional Modifier 53 Low / Median / High Price $74.13 / $147.91 / $302.00	Professional	53	$74.13	$147.91	$302.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $776.25 / $1,905.46	Facility		$446.68	$776.25	$1,905.46
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $602.56 / $912.01	Professional		$446.68	$602.56	$912.01
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $331.13 / $398.11	Facility		$204.17	$331.13	$398.11
UPMC Health Plan Facility/Professional Facility Modifier 53 Low / Median / High Price $52.48 / $89.13 / $109.65	Facility	53	$52.48	$89.13	$109.65
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $323.59 / $416.87	Professional		$77.62	$323.59	$416.87
UPMC Health Plan Facility/Professional Professional Modifier 53 Low / Median / High Price $52.48 / $109.65 / $165.96	Professional	53	$52.48	$109.65	$165.96
United Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $1,258.93 / $3,715.35	Facility		$323.59	$1,258.93	$3,715.35
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $302.00 / $524.81	Professional		$173.78	$302.00	$524.81
United Facility/Professional Professional Modifier 53 Low / Median / High Price $204.17 / $204.17 / $204.17	Professional	53	$204.17	$204.17	$204.17