Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $288.40 / $288.40	Facility		$74.13	$288.40	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $102.33 / $208.93	Professional		$72.44	$102.33	$208.93
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 $181.97 / $181.97 / $181.97	Professional		$181.97	$181.97	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $181.97	Facility		$117.49	$117.49	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $117.49	Professional		$85.11	$85.11	$117.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $346.74	Professional		$169.82	$239.88	$346.74
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $181.97 / $181.97	Facility		$181.97	$181.97	$181.97
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $128.82 / $181.97	Professional		$109.65	$128.82	$181.97
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $288.40	Facility		$74.13	$74.13	$288.40
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $107.15 / $213.80	Professional		$74.13	$107.15	$213.80
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $295.12	Facility		$67.61	$67.61	$295.12
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $295.12	Professional		$56.23	$56.23	$295.12
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $169.82	Facility		$128.82	$128.82	$169.82
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $173.78	Professional		$128.82	$169.82	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $245.47 / $295.12	Facility		$83.18	$245.47	$295.12
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $89.13 / $165.96	Professional		$74.13	$89.13	$165.96