Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $585.61 / $1,821.95 / $4,962.91	Facility		$585.61	$1,821.95	$4,962.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,064.00 / $1,276.80 / $3,277.60	Professional		$1,064.00	$1,276.80	$3,277.60
AmeriHealth Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,032.44 / $1,214.63 / $8,639.91	Facility		$1,032.44	$1,214.63	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $1,214.63	Professional		$1,214.63	$1,214.63	$1,214.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Facility		$1,238.93	$1,238.93	$1,238.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,072.91 / $2,122.46 / $5,558.35	Facility		$1,072.91	$2,122.46	$5,558.35
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,188.00 / $1,870.53 / $5,456.20	Facility		$1,188.00	$1,870.53	$5,456.20
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,049.24 / $1,388.15 / $2,574.98	Professional		$1,049.24	$1,388.15	$2,574.98
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Facility		$1,238.93	$1,238.93	$1,238.93
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,196.14 / $1,196.14 / $1,196.14	Facility		$1,196.14	$1,196.14	$1,196.14
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,196.14 / $1,196.14 / $1,196.14	Professional		$1,196.14	$1,196.14	$1,196.14
United Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $1,677.40	Professional		$1,214.63	$1,214.63	$1,677.40