Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $741.31 / $741.31	Facility		$190.55	$741.31	$741.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $213.80 / $363.08	Professional		$186.21	$213.80	$363.08
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 $426.58 / $426.58 / $426.58	Professional		$426.58	$426.58	$426.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $524.81	Facility		$275.42	$275.42	$524.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $275.42	Professional		$199.53	$199.53	$275.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $691.83 / $1,000.00	Professional		$489.78	$691.83	$1,000.00
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $436.52 / $436.52 / $436.52	Facility		$436.52	$436.52	$436.52
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $302.00 / $436.52	Professional		$257.04	$302.00	$436.52
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $741.31	Facility		$190.55	$190.55	$741.31
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $223.87 / $389.05	Professional		$186.21	$223.87	$389.05
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $851.14	Facility		$851.14	$851.14	$851.14
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $741.31 / $1,023.29	Professional		$0.60	$741.31	$1,023.29
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $302.00 / $407.38	Facility		$302.00	$302.00	$407.38
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $416.87	Professional		$302.00	$302.00	$416.87
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $524.81 / $630.96	Facility		$173.78	$524.81	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $239.88 / $380.19	Professional		$190.55	$239.88	$380.19