Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.84 / $278.58 / $496.16	Facility		$164.84	$278.58	$496.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $197.48	Professional		$164.25	$164.25	$197.48
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $152.13 / $178.20 / $8,459.92	Facility		$152.13	$178.20	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $170.45 / $170.45 / $170.45	Professional		$170.45	$170.45	$170.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.96 / $164.25 / $164.25	Facility		$154.96	$164.25	$164.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $164.45	Professional		$164.25	$164.25	$164.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $159.91 / $159.91 / $205.48	Professional		$159.91	$159.91	$205.48
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $164.84 / $247.26 / $496.16	Facility		$164.84	$247.26	$496.16
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $165.90 / $310.70	Professional		$164.25	$165.90	$310.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.40 / $229.60 / $279.20	Professional		$27.40	$229.60	$279.20
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $154.96 / $164.25 / $164.25	Facility		$154.96	$164.25	$164.25
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $164.25 / $170.45	Professional		$164.25	$164.25	$170.45
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $135.62 / $135.62 / $157.37	Facility		$135.62	$135.62	$157.37
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $135.62 / $135.62 / $157.37	Professional		$135.62	$135.62	$157.37
United Facility/Professional Professional Modifier Low / Median / High Price $164.25 / $174.11 / $237.88	Professional		$164.25	$174.11	$237.88