Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $3,162.28 / $3,162.28	Facility		$831.76	$3,162.28	$3,162.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,096.48 / $1,905.46	Professional		$831.76	$1,096.48	$1,905.46
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,511.38 / $77,624.71	Facility		$5,011.87	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $1,995.26 / $1,995.26	Professional		$1,995.26	$1,995.26	$1,995.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,318.26 / $1,318.26 / $2,187.76	Facility		$1,318.26	$1,318.26	$2,187.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $954.99 / $1,318.26	Professional		$954.99	$954.99	$1,318.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,995.26 / $2,884.03 / $4,168.69	Professional		$1,995.26	$2,884.03	$4,168.69
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $2,041.74 / $2,041.74 / $2,041.74	Facility		$2,041.74	$2,041.74	$2,041.74
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,445.44 / $2,041.74	Professional		$1,230.27	$1,445.44	$2,041.74
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $831.76 / $3,162.28	Facility		$831.76	$831.76	$3,162.28
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $1,096.48 / $2,089.30	Professional		$831.76	$1,096.48	$2,089.30
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $3,467.37 / $3,467.37	Facility		$3,467.37	$3,467.37	$3,467.37
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $3,090.30 / $4,265.80	Professional		$0.60	$3,090.30	$4,265.80
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,445.44 / $1,445.44 / $1,905.46	Facility		$1,445.44	$1,445.44	$1,905.46
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $1,905.46 / $2,089.30	Professional		$1,445.44	$1,905.46	$2,089.30
United Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $2,754.23 / $3,235.94	Facility		$1,000.00	$2,754.23	$3,235.94
United Facility/Professional Professional Modifier Low / Median / High Price $776.25 / $1,000.00 / $1,819.70	Professional		$776.25	$1,000.00	$1,819.70