Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.00 / $119.00 / $149.62	Facility		$119.00	$119.00	$149.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.72 / $167.70 / $353.00	Professional		$135.72	$167.70	$353.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $115.53 / $182.00 / $260.77	Professional	25	$115.53	$182.00	$260.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.00 / $167.14 / $242.35	Professional		$103.00	$167.14	$242.35
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $142.11 / $227.89 / $242.35	Professional	25	$142.11	$227.89	$242.35
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 $164.15 / $215.45 / $311.17	Professional		$164.15	$215.45	$311.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $187.13 / $187.13	Facility		$187.13	$187.13	$187.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $147.60	Professional		$147.60	$147.60	$147.60
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $363.80 / $363.80 / $363.80	Facility		$363.80	$363.80	$363.80
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $190.17 / $244.50 / $337.26	Professional		$190.17	$244.50	$337.26
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.41 / $157.81 / $180.35	Professional		$141.41	$157.81	$180.35
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $142.07 / $150.29 / $169.15	Professional	25	$142.07	$150.29	$169.15
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $119.00 / $119.00 / $149.62	Facility		$119.00	$119.00	$149.62
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $136.38 / $190.04 / $398.01	Professional		$136.38	$190.04	$398.01
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $115.53 / $208.45 / $261.45	Professional	25	$115.53	$208.45	$261.45
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $120.10 / $120.10 / $120.10	Facility		$120.10	$120.10	$120.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $120.10 / $229.19 / $360.74	Professional		$120.10	$229.19	$360.74
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $187.13 / $187.13	Facility		$187.13	$187.13	$187.13
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $147.60	Professional		$147.60	$147.60	$147.60
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $147.25 / $200.00 / $200.00	Facility		$147.25	$200.00	$200.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $157.41 / $169.44 / $204.00	Professional		$157.41	$169.44	$204.00
United Facility/Professional Professional Modifier Low / Median / High Price $144.32 / $190.01 / $325.24	Professional		$144.32	$190.01	$325.24