Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $478.63 / $478.63	Facility		$123.03	$478.63	$478.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $151.36 / $234.42	Professional		$112.20	$151.36	$234.42
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 $165.96 / $245.47 / $309.03	Professional		$165.96	$245.47	$309.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $263.03	Facility		$158.49	$158.49	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $158.49	Professional		$117.49	$117.49	$158.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $338.84 / $501.19	Professional		$239.88	$338.84	$501.19
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $309.03 / $309.03	Facility		$309.03	$309.03	$309.03
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $199.53 / $309.03	Professional		$181.97	$199.53	$309.03
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $478.63	Facility		$123.03	$123.03	$478.63
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $162.18 / $316.23	Professional		$114.82	$162.18	$316.23
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $416.87 / $416.87 / $416.87	Facility		$416.87	$416.87	$416.87
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $346.74 / $501.19	Professional		$0.60	$346.74	$501.19
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $288.40	Facility		$213.80	$213.80	$288.40
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $213.80 / $323.59	Professional		$128.82	$213.80	$323.59
United Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $346.74 / $416.87	Facility		$125.89	$346.74	$416.87
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $147.91 / $263.03	Professional		$107.15	$147.91	$263.03