Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $2,818.38 / $3,981.07	Facility		$1,445.44	$2,818.38	$3,981.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,318.26 / $2,137.96	Professional		$1,288.25	$1,318.26	$2,137.96
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,412.54 / $5,011.87	Facility		$1,202.26	$1,412.54	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Professional		$1,348.96	$1,348.96	$1,348.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility		$1,318.26	$1,318.26	$1,318.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,348.96	Professional		$1,318.26	$1,318.26	$1,348.96
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,258.93 / $1,318.26 / $1,548.82	Professional		$1,258.93	$1,318.26	$1,548.82
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility		$1,318.26	$1,318.26	$1,318.26
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $1,380.38 / $2,238.72	Professional		$501.19	$1,380.38	$2,238.72
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $2,570.40 / $3,981.07	Facility		$1,318.26	$2,570.40	$3,981.07
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,348.96 / $2,238.72	Professional		$1,288.25	$1,348.96	$2,238.72
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Facility		$2,630.27	$2,630.27	$2,630.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $1,819.70 / $3,235.94	Professional		$0.60	$1,819.70	$3,235.94
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,548.82 / $1,659.59	Facility		$1,445.44	$1,548.82	$1,659.59
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,548.82 / $1,659.59	Professional		$1,445.44	$1,548.82	$1,659.59
United Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility		$1,318.26	$1,318.26	$1,318.26
United Facility/Professional Professional Modifier Low / Median / High Price $1,318.26 / $1,380.38 / $1,862.09	Professional		$1,318.26	$1,380.38	$1,862.09