Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $166.48 / $435.18	Facility		$161.62	$166.48	$435.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $163.24	Professional		$161.62	$161.62	$163.24
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $137.38 / $161.62 / $242.43	Facility		$137.38	$161.62	$242.43
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $161.62	Professional		$161.62	$161.62	$161.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $161.62 / $161.62	Facility		$161.62	$161.62	$161.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $175.35	Professional		$161.62	$161.62	$175.35
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $218.85	Professional		$161.62	$161.62	$218.85
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $161.62 / $166.48 / $435.18	Facility		$161.62	$166.48	$435.18
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $198.11	Professional		$161.62	$161.62	$198.11
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $152.47 / $161.62 / $161.62	Facility		$152.47	$161.62	$161.62
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $161.62 / $161.62 / $182.97	Professional		$161.62	$161.62	$182.97
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 $161.62 / $161.62 / $295.76	Professional		$161.62	$161.62	$295.76