Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.07 / $106.70 / $235.44	Facility		$90.07	$106.70	$235.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $109.90	Professional		$106.70	$106.70	$109.90
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $91.09 / $106.70 / $8,639.91	Facility		$91.09	$106.70	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $106.70	Professional		$106.70	$106.70	$106.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.70 / $106.70 / $106.70	Facility		$106.70	$106.70	$106.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $110.73	Professional		$106.70	$106.70	$110.73
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $144.47	Professional		$106.70	$106.70	$144.47
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $90.07 / $106.70 / $235.44	Facility		$90.07	$106.70	$235.44
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $154.71	Professional		$106.70	$106.70	$154.71
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $100.66 / $106.70 / $106.70	Facility		$100.66	$106.70	$106.70
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $120.79	Professional		$106.70	$106.70	$120.79
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $373.33 / $373.33 / $433.21	Facility		$373.33	$373.33	$433.21
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $373.33 / $373.33 / $433.21	Professional		$373.33	$373.33	$433.21
United Facility/Professional Facility Modifier Low / Median / High Price $89.18 / $89.18 / $89.18	Facility		$89.18	$89.18	$89.18
United Facility/Professional Professional Modifier Low / Median / High Price $106.70 / $106.70 / $195.26	Professional		$106.70	$106.70	$195.26