Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $208.93 / $208.93	Facility		$53.70	$208.93	$208.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $69.18 / $134.90	Professional		$53.70	$69.18	$134.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $120.23 / $123.03	Professional		$75.86	$120.23	$123.03
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 $123.03 / $123.03 / $123.03	Professional		$123.03	$123.03	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $128.82	Facility		$89.13	$89.13	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $89.13	Professional		$64.57	$64.57	$89.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $169.82 / $245.47	Professional		$117.49	$169.82	$245.47
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $123.03 / $123.03	Facility		$123.03	$123.03	$123.03
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $87.10 / $123.03	Professional		$74.13	$87.10	$123.03
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $85.11 / $91.20	Professional		$83.18	$85.11	$91.20
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $53.70 / $208.93	Facility		$53.70	$53.70	$208.93
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $72.44 / $147.91	Professional		$53.70	$72.44	$147.91
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $173.78 / $251.19	Professional		$0.60	$173.78	$251.19
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $85.11 / $114.82	Facility		$74.13	$85.11	$114.82
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $85.11 / $181.97	Professional		$74.13	$85.11	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $165.96 / $199.53	Facility		$54.95	$165.96	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $69.18 / $117.49	Professional		$54.95	$69.18	$117.49