Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.54 / $92.31 / $152.62	Facility		$61.54	$92.31	$152.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.92 / $61.54 / $66.52	Professional		$57.92	$61.54	$66.52
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $60.10 / $8,459.92	Facility		$51.31	$60.10	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $60.10 / $60.10 / $60.10	Professional		$60.10	$60.10	$60.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.54 / $61.54 / $61.54	Facility		$61.54	$61.54	$61.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.54 / $61.54 / $61.54	Professional		$61.54	$61.54	$61.54
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $61.54 / $61.54 / $80.01	Professional		$61.54	$61.54	$80.01
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $61.54 / $92.31 / $152.62	Facility		$61.54	$92.31	$152.62
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $57.92 / $61.54 / $151.38	Professional		$57.92	$61.54	$151.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $27.40 / $79.90 / $143.90	Professional		$27.40	$79.90	$143.90
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $61.54 / $61.54 / $61.54	Facility		$61.54	$61.54	$61.54
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $61.54 / $61.54 / $61.54	Professional		$61.54	$61.54	$61.54
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $63.96 / $63.96 / $74.20	Facility		$63.96	$63.96	$74.20
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $63.96 / $63.96 / $74.20	Professional		$63.96	$63.96	$74.20
United Facility/Professional Professional Modifier Low / Median / High Price $60.34 / $63.96 / $77.23	Professional		$60.34	$63.96	$77.23