Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.31 / $10.17 / $20.69	Facility		$8.31	$10.17	$20.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.80 / $15.31 / $23.90	Professional		$7.80	$15.31	$23.90
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $22.26 / $22.54 / $23.10	Professional	25	$22.26	$22.54	$23.10
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $3.95 / $5.51 / $10.00	Professional	52	$3.95	$5.51	$10.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.12 / $17.92 / $29.57	Professional		$16.12	$17.92	$29.57
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $16.37 / $20.44 / $33.77	Professional		$16.37	$20.44	$33.77
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 $17.30 / $17.95 / $32.54	Professional		$17.30	$17.95	$32.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12.08 / $12.08 / $12.08	Facility		$12.08	$12.08	$12.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $15.77 / $15.77 / $15.77	Professional		$15.77	$15.77	$15.77
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $19.66 / $19.66 / $19.66	Facility		$19.66	$19.66	$19.66
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $20.53 / $26.41 / $35.81	Professional		$20.53	$26.41	$35.81
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.51 / $21.55 / $22.54	Professional		$18.51	$21.55	$22.54
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $18.51 / $18.51 / $18.97	Professional	25	$18.51	$18.51	$18.97
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $17.04 / $20.67 / $33.77	Professional		$17.04	$20.67	$33.77
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $8.31 / $10.17 / $16.30	Facility		$8.31	$10.17	$16.30
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $8.31 / $16.30 / $30.19	Professional		$8.31	$16.30	$30.19
Martin's Point Facility/Professional Professional Modifier 25 Low / Median / High Price $17.54 / $22.26 / $22.54	Professional	25	$17.54	$22.26	$22.54
Martin's Point Facility/Professional Professional Modifier 52 Low / Median / High Price $4.16 / $6.73 / $10.35	Professional	52	$4.16	$6.73	$10.35
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.80 / $24.15 / $40.50	Professional		$9.80	$24.15	$40.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $12.08 / $12.08 / $12.08	Facility		$12.08	$12.08	$12.08
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $15.77 / $15.77 / $15.77	Professional		$15.77	$15.77	$15.77
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $8.36 / $17.79 / $17.79	Facility		$8.36	$17.79	$17.79
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $15.30 / $19.04	Professional		$8.71	$15.30	$19.04
United Facility/Professional Professional Modifier Low / Median / High Price $15.66 / $19.57 / $33.78	Professional		$15.66	$19.57	$33.78