Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $181.97 / $181.97	Facility		$109.65	$181.97	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $34.67 / $79.43	Professional		$16.98	$34.67	$79.43
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $199.53 / $213.80	Facility		$107.15	$199.53	$213.80
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Professional		$34.67	$34.67	$34.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $74.13 / $74.13	Facility		$70.79	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $22.91	Professional		$22.91	$22.91	$22.91
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $58.88 / $95.50	Professional		$45.71	$58.88	$95.50
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $67.61 / $112.20	Professional		$43.65	$67.61	$112.20
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $181.97 / $181.97	Facility		$109.65	$181.97	$181.97
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $36.31 / $114.82	Professional		$16.98	$36.31	$114.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $0.60 / $0.60	Professional		$0.60	$0.60	$0.60
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $43.65 / $138.04	Professional		$18.62	$43.65	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $26.30 / $54.95	Professional		$18.62	$26.30	$54.95