Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.95 / $62.95 / $243.62	Facility		$62.95	$62.95	$243.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.95 / $73.67 / $114.06	Professional		$62.95	$73.67	$114.06
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 $110.18 / $123.97 / $123.97	Professional		$110.18	$123.97	$123.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.97 / $133.72 / $133.72	Facility		$123.97	$133.72	$133.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.62 / $97.62 / $160.50	Professional		$97.62	$97.62	$160.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $114.05 / $123.97 / $235.54	Professional		$114.05	$123.97	$235.54
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $62.95 / $62.95 / $243.62	Facility		$62.95	$62.95	$243.62
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $62.95 / $72.33 / $122.60	Professional		$62.95	$72.33	$122.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.59 / $100.70 / $327.00	Professional		$76.59	$100.70	$327.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $123.97 / $133.72 / $133.72	Facility		$123.97	$133.72	$133.72
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $97.62 / $97.62 / $160.50	Professional		$97.62	$97.62	$160.50
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $137.72 / $137.72 / $142.62	Facility		$137.72	$137.72	$142.62
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $133.91 / $137.72 / $144.84	Professional		$133.91	$137.72	$144.84
United Facility/Professional Professional Modifier Low / Median / High Price $74.38 / $99.52 / $174.30	Professional		$74.38	$99.52	$174.30