Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $181.97 / $234.42	Facility		$77.62	$181.97	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $109.65	Professional		$77.62	$77.62	$109.65
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $83.18 / $5,011.87	Facility		$70.79	$83.18	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Professional		$77.62	$77.62	$77.62
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $134.90 / $134.90	Professional		$117.49	$134.90	$134.90
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $154.88 / $234.42	Facility		$77.62	$154.88	$234.42
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $213.80	Professional		$77.62	$77.62	$213.80
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $81.28 / $91.20	Facility		$69.18	$81.28	$91.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $81.28 / $91.20	Professional		$69.18	$81.28	$91.20
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $77.62	Facility		$77.62	$77.62	$77.62
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $107.15	Professional		$77.62	$77.62	$107.15