Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $2,454.71 / $2,454.71	Facility		$630.96	$2,454.71	$2,454.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $794.33 / $1,412.54	Professional		$630.96	$794.33	$1,412.54
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 $1,548.82 / $1,548.82 / $1,548.82	Professional		$1,548.82	$1,548.82	$1,548.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,584.89	Facility		$1,122.02	$1,122.02	$1,584.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $812.83 / $1,122.02	Professional		$812.83	$812.83	$1,122.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,445.44 / $2,089.30 / $3,019.95	Professional		$1,445.44	$2,089.30	$3,019.95
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility		$1,584.89	$1,584.89	$1,584.89
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,096.48 / $1,584.89	Professional		$954.99	$1,096.48	$1,584.89
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $630.96 / $2,454.71	Facility		$630.96	$630.96	$2,454.71
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $630.96 / $812.83 / $1,513.56	Professional		$630.96	$812.83	$1,513.56
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,511.89 / $2,511.89 / $2,511.89	Facility		$2,511.89	$2,511.89	$2,511.89
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $2,187.76 / $3,090.30	Professional		$0.60	$2,187.76	$3,090.30
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,479.11	Facility		$1,096.48	$1,096.48	$1,479.11
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,096.48 / $1,513.56	Professional		$1,096.48	$1,096.48	$1,513.56
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $1,949.84 / $2,290.87	Facility		$707.95	$1,949.84	$2,290.87
United Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $776.25 / $1,412.54	Professional		$588.84	$776.25	$1,412.54