Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $19.95 / $30.90	Facility		$19.95	$19.95	$30.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $26.92 / $87.10	Professional		$19.05	$26.92	$87.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $28.84	Professional		$28.84	$28.84	$28.84
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
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $67.61 / $67.61	Facility		$67.61	$67.61	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $16.98 / $16.98	Professional		$16.98	$16.98	$16.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $61.66 / $93.33	Professional		$44.67	$61.66	$93.33
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $42.66	Facility		$42.66	$42.66	$42.66
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $29.51 / $42.66	Professional		$25.70	$29.51	$42.66
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $25.12 / $30.90	Facility		$19.95	$25.12	$30.90
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $26.92 / $48.98	Professional		$19.05	$26.92	$48.98
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $60.26 / $67.61	Facility		$60.26	$60.26	$67.61
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $60.26 / $83.18	Professional		$0.60	$60.26	$83.18
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $24.55 / $39.81	Facility		$24.55	$24.55	$39.81
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $24.55 / $63.10	Professional		$24.55	$24.55	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $20.89 / $34.67	Professional		$16.22	$20.89	$34.67