Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $302.00 / $302.00	Facility		$77.62	$302.00	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $109.65 / $177.83	Professional		$77.62	$109.65	$177.83
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 $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $194.98	Facility		$120.23	$120.23	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $120.23	Professional		$87.10	$87.10	$120.23
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $257.04 / $371.54	Professional		$177.83	$257.04	$371.54
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $134.90 / $194.98	Professional		$117.49	$134.90	$194.98
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $302.00	Facility		$77.62	$77.62	$302.00
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $114.82 / $229.09	Professional		$77.62	$114.82	$229.09
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $263.03 / $380.19	Professional		$0.60	$263.03	$380.19
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $181.97	Facility		$138.04	$138.04	$181.97
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $239.88	Professional		$138.04	$138.04	$239.88
United Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $257.04 / $309.03	Facility		$93.33	$257.04	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $95.50 / $177.83	Professional		$79.43	$95.50	$177.83