Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $199.53 / $316.23	Facility		$107.15	$199.53	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $107.15 / $144.54	Professional		$104.71	$107.15	$144.54
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $114.82 / $5,011.87	Facility		$97.72	$114.82	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $109.65	Professional		$104.71	$104.71	$109.65
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $114.82 / $128.82	Professional		$104.71	$114.82	$128.82
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $104.71 / $104.71	Facility		$100.00	$104.71	$104.71
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $109.65 / $181.97	Professional		$79.43	$109.65	$181.97
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $199.53 / $316.23	Facility		$107.15	$199.53	$316.23
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $107.15 / $173.78	Professional		$104.71	$107.15	$173.78
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $30.20 / $194.98	Professional		$0.60	$30.20	$194.98
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $89.13 / $114.82	Facility		$36.31	$89.13	$114.82
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $87.10 / $114.82	Professional		$27.54	$87.10	$114.82
United Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Facility		$104.71	$104.71	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $112.20 / $125.89	Professional		$104.71	$112.20	$125.89