Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $107.15	Facility		$72.44	$72.44	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $95.50 / $218.78	Professional		$72.44	$95.50	$218.78
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 $147.91 / $147.91 / $147.91	Professional		$147.91	$147.91	$147.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $234.42 / $234.42 / $234.42	Facility		$234.42	$234.42	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $60.26 / $60.26	Professional		$60.26	$60.26	$60.26
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $218.78 / $323.59	Professional		$158.49	$218.78	$323.59
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Facility		$151.36	$151.36	$151.36
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $104.71 / $151.36	Professional		$91.20	$104.71	$151.36
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $89.13 / $107.15	Facility		$72.44	$89.13	$107.15
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $97.72 / $162.18	Professional		$72.44	$97.72	$162.18
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $239.88 / $239.88 / $239.88	Facility		$239.88	$239.88	$239.88
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $218.78 / $288.40	Professional		$0.60	$218.78	$288.40
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $11.48 / $87.10 / $141.25	Facility		$11.48	$87.10	$141.25
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $87.10 / $144.54	Professional		$19.95	$87.10	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $74.13 / $123.03	Professional		$57.54	$74.13	$123.03