Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.42 / $125.36 / $157.91	Facility		$28.42	$125.36	$157.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.07 / $33.52 / $48.18	Professional		$28.07	$33.52	$48.18
AmeriHealth Facility/Professional Facility Modifier Low / Median / High Price $253.28 / $253.28 / $253.28	Facility		$253.28	$253.28	$253.28
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $166.27 / $221.56 / $8,459.92	Facility		$166.27	$221.56	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $27.37 / $27.37 / $27.37	Professional		$27.37	$27.37	$27.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.29 / $51.76 / $116.27	Facility		$33.29	$51.76	$116.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.45 / $18.45 / $18.45	Professional		$18.45	$18.45	$18.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $36.84 / $47.37 / $86.67	Professional		$36.84	$47.37	$86.67
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.40 / $82.04 / $137.99	Facility		$45.40	$82.04	$137.99
Independence Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $253.28 / $253.28 / $320.88	Facility		$253.28	$253.28	$320.88
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $26.49 / $97.20 / $156.59	Facility		$26.49	$97.20	$156.59
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $28.07 / $33.52 / $144.91	Professional		$28.07	$33.52	$144.91
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $92.56 / $95.64 / $133.04	Facility		$92.56	$95.64	$133.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $51.93 / $52.63 / $70.18	Professional		$51.93	$52.63	$70.18
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $34.00 / $56.69 / $116.27	Facility		$34.00	$56.69	$116.27
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $18.45 / $18.45 / $18.45	Professional		$18.45	$18.45	$18.45
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $35.09 / $52.95	Facility		$35.09	$35.09	$52.95
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $35.09 / $52.95	Professional		$35.09	$35.09	$52.95
United Facility/Professional Professional Modifier Low / Median / High Price $14.74 / $21.05 / $64.20	Professional		$14.74	$21.05	$64.20