Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $28.13 / $28.13 / $108.86	Facility		$28.13	$28.13	$108.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.67 / $29.36 / $33.57	Professional		$23.67	$29.36	$33.57
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 $47.96 / $62.99 / $62.99	Professional		$47.96	$62.99	$62.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.54 / $34.54 / $64.01	Facility		$34.54	$34.54	$64.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.21 / $25.21 / $56.05	Professional		$25.21	$25.21	$56.05
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $58.89 / $64.01 / $121.62	Professional		$58.89	$64.01	$121.62
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $28.13 / $28.13 / $108.86	Facility		$28.13	$28.13	$108.86
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $23.53 / $29.38 / $40.36	Professional		$23.53	$29.38	$40.36
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $43.40 / $87.30 / $126.10	Professional		$43.40	$87.30	$126.10
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $34.54 / $34.54 / $64.01	Facility		$34.54	$34.54	$64.01
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $25.21 / $25.21 / $64.13	Professional		$25.21	$25.21	$64.13
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $30.10 / $30.10 / $59.95	Facility		$30.10	$30.10	$59.95
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $30.10 / $59.95 / $60.93	Professional		$30.10	$59.95	$60.93
United Facility/Professional Professional Modifier Low / Median / High Price $28.40 / $36.60 / $56.80	Professional		$28.40	$36.60	$56.80