Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.26 / $122.60 / $125.31	Facility		$102.26	$122.60	$125.31
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $125.30 / $125.30 / $125.30	Facility	25	$125.30	$125.30	$125.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.68 / $126.10 / $235.33	Professional		$90.68	$126.10	$235.33
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $117.48 / $139.27 / $207.12	Professional	25	$117.48	$139.27	$207.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.11 / $131.90 / $217.64	Professional		$112.11	$131.90	$217.64
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $122.89 / $152.00 / $191.26	Professional	25	$122.89	$152.00	$191.26
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $132.66 / $143.72 / $230.64	Professional		$132.66	$143.72	$230.64
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 $129.08 / $143.07 / $216.73	Professional		$129.08	$143.07	$216.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $146.59 / $146.59 / $146.59	Facility		$146.59	$146.59	$146.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $116.36 / $116.36	Professional		$116.36	$116.36	$116.36
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $287.36 / $287.36 / $287.36	Facility		$287.36	$287.36	$287.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $150.41 / $193.40 / $265.35	Professional		$150.41	$193.40	$265.35
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.19 / $131.25 / $158.49	Professional		$118.19	$131.25	$158.49
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $111.48 / $126.40 / $155.38	Professional	25	$111.48	$126.40	$155.38
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $143.81 / $230.64	Professional		$131.90	$143.81	$230.64
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $102.26 / $122.60 / $125.31	Facility		$102.26	$122.60	$125.31
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $125.30 / $125.30 / $125.30	Facility	25	$125.30	$125.30	$125.30
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $103.04 / $134.99 / $269.64	Professional		$103.04	$134.99	$269.64
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $113.55 / $139.27 / $205.99	Professional	25	$113.55	$139.27	$205.99
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $99.10 / $99.10 / $99.10	Facility		$99.10	$99.10	$99.10
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $99.10 / $180.22 / $265.70	Professional		$99.10	$180.22	$265.70
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $146.59 / $146.59 / $146.59	Facility		$146.59	$146.59	$146.59
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $116.36 / $116.36	Professional		$116.36	$116.36	$116.36
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $97.78 / $175.00 / $175.00	Facility		$97.78	$175.00	$175.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $123.07 / $132.58 / $178.50	Professional		$123.07	$132.58	$178.50
United Facility/Professional Professional Modifier Low / Median / High Price $102.05 / $129.09 / $217.69	Professional		$102.05	$129.09	$217.69