Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $101.72 / $101.72 / $265.89	Facility		$101.72	$101.72	$265.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $104.77	Professional		$101.72	$101.72	$104.77
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $86.84 / $101.72 / $8,639.91	Facility		$86.84	$101.72	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $101.72	Professional		$101.72	$101.72	$101.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $101.72 / $101.72 / $101.72	Facility		$101.72	$101.72	$101.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $105.55	Professional		$101.72	$101.72	$105.55
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $105.56 / $110.35 / $137.72	Professional		$105.56	$110.35	$137.72
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $101.72 / $101.72 / $265.89	Facility		$101.72	$101.72	$265.89
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $171.91	Professional		$101.72	$101.72	$171.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $186.90 / $227.30 / $227.30	Professional		$186.90	$227.30	$227.30
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $95.96 / $101.72 / $101.72	Facility		$95.96	$101.72	$101.72
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $115.15	Professional		$101.72	$101.72	$115.15
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $99.91 / $99.91 / $115.93	Facility		$99.91	$99.91	$115.93
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $99.91 / $99.91 / $115.93	Professional		$99.91	$99.91	$115.93
United Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.72 / $175.31	Professional		$101.72	$101.72	$175.31