Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $677.38 / $677.38 / $2,621.46	Facility		$677.38	$677.38	$2,621.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $644.11 / $749.44 / $905.75	Professional		$644.11	$749.44	$905.75
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,000.00 / $8,639.91 / $79,506.39	Facility		$5,000.00	$8,639.91	$79,506.39
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,253.30 / $1,645.94 / $1,645.94	Professional		$1,253.30	$1,645.94	$1,645.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $941.33 / $941.33 / $1,645.94	Facility		$941.33	$941.33	$1,645.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $687.17 / $687.17 / $1,441.24	Professional		$687.17	$687.17	$1,441.24
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,514.26 / $1,645.94 / $3,127.29	Professional		$1,514.26	$1,645.94	$3,127.29
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $677.38 / $677.38 / $2,621.46	Facility		$677.38	$677.38	$2,621.46
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $560.33 / $778.27 / $910.40	Professional		$560.33	$778.27	$910.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $2,040.80 / $2,346.90 / $3,242.80	Professional		$2,040.80	$2,346.90	$3,242.80
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $941.33 / $941.33 / $1,645.94	Facility		$941.33	$941.33	$1,645.94
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $687.17 / $687.17 / $1,954.88	Professional		$687.17	$687.17	$1,954.88
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,176.78 / $1,566.63 / $1,566.63	Facility		$1,176.78	$1,566.63	$1,566.63
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,176.78 / $1,566.63 / $1,605.08	Professional		$1,176.78	$1,566.63	$1,605.08
United Facility/Professional Professional Modifier Low / Median / High Price $622.66 / $829.35 / $1,484.32	Professional		$622.66	$829.35	$1,484.32