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 $75.86 / $102.33 / $190.55	Professional		$75.86	$102.33	$190.55
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 $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $213.80	Facility		$112.20	$112.20	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $112.20	Professional		$83.18	$83.18	$112.20
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $281.84 / $407.38	Professional		$199.53	$281.84	$407.38
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $125.89 / $177.83	Professional		$107.15	$125.89	$177.83
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 $75.86 / $107.15 / $194.98	Professional		$75.86	$107.15	$194.98
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Facility		$338.84	$338.84	$338.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $288.40 / $416.87	Professional		$0.60	$288.40	$416.87
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $83.18 / $165.96	Facility		$83.18	$83.18	$165.96
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $87.10 / $309.03	Professional		$83.18	$87.10	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $239.88 / $288.40	Facility		$79.43	$239.88	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $104.71 / $162.18	Professional		$79.43	$104.71	$162.18