Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $104.71 / $162.18	Facility		$53.70	$104.71	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $53.70 / $74.13	Professional		$52.48	$53.70	$74.13
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $57.54 / $5,011.87	Facility		$48.98	$57.54	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $53.70 / $54.95	Professional		$53.70	$53.70	$54.95
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $64.57	Professional		$52.48	$52.48	$64.57
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $91.20	Professional		$32.36	$54.95	$91.20
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $102.33 / $162.18	Facility		$53.70	$102.33	$162.18
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $53.70 / $87.10	Professional		$52.48	$53.70	$87.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $79.43 / $79.43	Facility		$79.43	$79.43	$79.43
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $30.20 / $97.72	Professional		$0.60	$30.20	$97.72
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $23.99 / $53.70 / $112.20	Facility		$23.99	$53.70	$112.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $45.71 / $74.13	Professional		$28.18	$45.71	$74.13
United Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $53.70	Facility		$53.70	$53.70	$53.70
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $56.23 / $63.10	Professional		$52.48	$56.23	$63.10