Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $150.80 / $541.12 / $1,321.29	Facility		$150.80	$541.12	$1,321.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.68 / $180.00 / $226.80	Professional		$100.68	$180.00	$226.80
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $154.13 / $285.50 / $1,264.80	Facility		$154.13	$285.50	$1,264.80
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $192.50 / $226.47 / $371.29	Professional		$192.50	$226.47	$371.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.96 / $112.96 / $112.96	Facility		$112.96	$112.96	$112.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.91 / $78.91 / $78.91	Professional		$78.91	$78.91	$78.91
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $100.49 / $138.47 / $193.53	Professional		$100.49	$138.47	$193.53
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $200.80 / $415.42 / $754.07	Facility		$200.80	$415.42	$754.07
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.08 / $200.62 / $200.62	Professional		$160.08	$200.62	$200.62
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $152.33 / $266.64 / $1,184.80	Facility		$152.33	$266.64	$1,184.80
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $150.52 / $491.45 / $981.00	Facility		$150.52	$491.45	$981.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $103.46 / $180.00 / $293.32	Professional		$103.46	$180.00	$293.32
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $349.49 / $349.49 / $349.49	Facility		$349.49	$349.49	$349.49
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $233.70 / $233.70 / $406.02	Professional		$233.70	$233.70	$406.02
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $112.96 / $112.96 / $112.96	Facility		$112.96	$112.96	$112.96
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $78.91 / $78.91 / $78.91	Professional		$78.91	$78.91	$78.91
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $98.10 / $98.10 / $182.28	Facility		$98.10	$98.10	$182.28
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $88.48 / $98.10 / $105.50	Professional		$88.48	$98.10	$105.50
United Facility/Professional Professional Modifier Low / Median / High Price $122.19 / $205.88 / $399.37	Professional		$122.19	$205.88	$399.37