Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.05 / $75.05 / $149.62	Facility		$75.05	$75.05	$149.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $147.01 / $251.60	Professional		$105.00	$147.01	$251.60
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $159.97 / $261.39 / $350.00	Professional	25	$159.97	$261.39	$350.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $148.38 / $156.49 / $164.27	Professional		$148.38	$156.49	$164.27
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $153.60 / $153.60 / $156.49	Professional	25	$153.60	$153.60	$156.49
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 $164.47 / $170.68 / $302.49	Professional		$164.47	$170.68	$302.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.07 / $174.07 / $174.07	Facility		$174.07	$174.07	$174.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $283.42 / $283.42 / $283.42	Facility		$283.42	$283.42	$283.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $190.56 / $245.01 / $337.93	Professional		$190.56	$245.01	$337.93
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.60 / $150.60 / $150.60	Professional		$150.60	$150.60	$150.60
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $75.05 / $75.05 / $149.62	Facility		$75.05	$75.05	$149.62
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $118.93 / $166.89 / $363.26	Professional		$118.93	$166.89	$363.26
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $159.97 / $261.39 / $404.00	Professional	25	$159.97	$261.39	$404.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $105.30 / $105.30 / $105.30	Facility		$105.30	$105.30	$105.30
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $105.30 / $190.29 / $338.60	Professional		$105.30	$190.29	$338.60
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $174.07 / $174.07 / $174.07	Facility		$174.07	$174.07	$174.07
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $83.63 / $200.00 / $200.00	Facility		$83.63	$200.00	$200.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $115.77 / $133.59 / $200.00	Professional		$115.77	$133.59	$200.00
United Facility/Professional Professional Modifier Low / Median / High Price $103.41 / $177.84 / $292.95	Professional		$103.41	$177.84	$292.95