Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.85 / $102.85 / $102.85	Facility		$102.85	$102.85	$102.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.80 / $102.85 / $102.85	Professional		$96.80	$102.85	$102.85
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $85.74 / $100.43 / $8,639.91	Facility		$85.74	$100.43	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $100.43 / $100.43 / $100.43	Professional		$100.43	$100.43	$100.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $102.85 / $102.85 / $102.85	Facility		$102.85	$102.85	$102.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.85 / $102.85 / $102.85	Professional		$102.85	$102.85	$102.85
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $102.85 / $108.90 / $108.90	Professional		$102.85	$108.90	$108.90
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $102.85 / $102.85 / $173.82	Facility		$102.85	$102.85	$173.82
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $96.80 / $102.85 / $122.39	Professional		$96.80	$102.85	$122.39
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $102.85 / $102.85 / $102.85	Facility		$102.85	$102.85	$102.85
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $102.85 / $102.85 / $102.85	Professional		$102.85	$102.85	$102.85
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $29.92 / $29.92 / $29.92	Facility		$29.92	$29.92	$29.92
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $29.92 / $29.92 / $30.52	Professional		$29.92	$29.92	$30.52
United Facility/Professional Professional Modifier Low / Median / High Price $110.00 / $110.00 / $151.91	Professional		$110.00	$110.00	$151.91