Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $2,344.23 / $2,344.23	Facility		$602.56	$2,344.23	$2,344.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $776.25 / $1,548.82	Professional		$602.56	$776.25	$1,548.82
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 $812.83 / $1,202.26 / $1,479.11	Professional		$812.83	$1,202.26	$1,479.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $891.25 / $1,621.81	Facility		$891.25	$891.25	$1,621.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $645.65 / $891.25	Professional		$645.65	$645.65	$891.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,479.11 / $2,089.30 / $3,090.30	Professional		$1,479.11	$2,089.30	$3,090.30
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $1,479.11 / $1,479.11 / $1,479.11	Facility		$1,479.11	$1,479.11	$1,479.11
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $891.25 / $1,047.13 / $1,479.11	Professional		$891.25	$1,047.13	$1,479.11
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $2,344.23	Facility		$602.56	$602.56	$2,344.23
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $794.33 / $1,819.70	Professional		$602.56	$794.33	$1,819.70
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $2,570.40	Facility		$2,570.40	$2,570.40	$2,570.40
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $2,137.96 / $3,090.30	Professional		$0.60	$2,137.96	$3,090.30
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,380.38	Facility		$1,047.13	$1,047.13	$1,380.38
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,047.13 / $1,380.38	Professional		$1,047.13	$1,047.13	$1,380.38
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,862.09 / $2,238.72	Facility		$676.08	$1,862.09	$2,238.72
United Facility/Professional Professional Modifier Low / Median / High Price $575.44 / $724.44 / $1,318.26	Professional		$575.44	$724.44	$1,318.26