Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $828.84 / $828.84 / $3,207.61	Facility		$828.84	$828.84	$3,207.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $788.13 / $952.28 / $1,282.10	Professional		$788.13	$952.28	$1,282.10
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 $1,533.52 / $2,013.95 / $2,013.95	Professional		$1,533.52	$2,013.95	$2,013.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,544.16 / $1,544.16 / $2,013.95	Facility		$1,544.16	$1,544.16	$2,013.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,127.24 / $1,127.24 / $1,763.48	Professional		$1,127.24	$1,127.24	$1,763.48
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,852.83 / $2,013.95 / $3,826.51	Professional		$1,852.83	$2,013.95	$3,826.51
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $828.84 / $828.84 / $3,207.61	Facility		$828.84	$828.84	$3,207.61
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $788.13 / $952.28 / $1,511.99	Professional		$788.13	$952.28	$1,511.99
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,364.00 / $2,746.80 / $3,967.80	Professional		$1,364.00	$2,746.80	$3,967.80
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $1,544.16 / $1,544.16 / $2,013.95	Facility		$1,544.16	$1,544.16	$2,013.95
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $1,127.24 / $1,127.24 / $2,767.50	Professional		$1,127.24	$1,127.24	$2,767.50
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,439.89 / $1,916.90 / $1,916.90	Facility		$1,439.89	$1,916.90	$1,916.90
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,439.89 / $1,916.90 / $2,272.03	Professional		$1,439.89	$1,916.90	$2,272.03
United Facility/Professional Professional Modifier Low / Median / High Price $842.12 / $1,014.78 / $1,863.93	Professional		$842.12	$1,014.78	$1,863.93