Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $123.03 / $125.89	Facility		$102.33	$123.03	$125.89
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	25	$125.89	$125.89	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $131.83 / $245.47	Professional		$91.20	$131.83	$245.47
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $102.33 / $144.54 / $218.78	Professional	25	$102.33	$144.54	$218.78
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	52	$123.03	$123.03	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $120.23 / $151.36	Professional		$102.33	$120.23	$151.36
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $100.00 / $123.03 / $162.18	Professional	25	$100.00	$123.03	$162.18
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $8,511.38 / $8,511.38 / $77,624.71	Facility		$8,511.38	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $134.90 / $190.55	Professional		$120.23	$134.90	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $204.17 / $204.17	Facility		$95.50	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Professional		$117.49	$117.49	$117.49
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $288.40	Professional		$158.49	$199.53	$288.40
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $169.82 / $263.03	Professional		$131.83	$169.82	$263.03
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $131.83 / $162.18	Professional		$112.20	$131.83	$162.18
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $117.49 / $120.23 / $131.83	Professional	25	$117.49	$120.23	$131.83
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $117.49 / $125.89	Facility		$102.33	$117.49	$125.89
Martin's Point Facility/Professional Facility Modifier 25 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	25	$125.89	$125.89	$125.89
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $134.90 / $251.19	Professional		$97.72	$134.90	$251.19
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $102.33 / $141.25 / $218.78	Professional	25	$102.33	$141.25	$218.78
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	52	$123.03	$123.03	$123.03
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $263.03	Facility		$100.00	$100.00	$263.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $199.53 / $263.03	Professional		$100.00	$199.53	$263.03
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $97.72 / $173.78	Facility		$26.92	$97.72	$173.78
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $125.89 / $177.83	Professional		$26.92	$125.89	$177.83
United Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $151.36 / $151.36	Facility		$138.04	$151.36	$151.36
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $125.89 / $199.53	Professional		$97.72	$125.89	$199.53