Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.80 / $127.32 / $332.80	Facility		$123.80	$127.32	$332.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $127.52	Professional		$123.80	$123.80	$127.52
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $105.69 / $123.80 / $8,639.91	Facility		$105.69	$123.80	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $123.80	Professional		$123.80	$123.80	$123.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.80 / $123.80 / $123.80	Facility		$123.80	$123.80	$123.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $138.69	Professional		$123.80	$123.80	$138.69
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $167.63	Professional		$123.80	$123.80	$167.63
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $123.80 / $127.32 / $332.80	Facility		$123.80	$127.32	$332.80
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $125.04 / $151.51	Professional		$123.80	$125.04	$151.51
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $116.79 / $123.80 / $123.80	Facility		$116.79	$123.80	$123.80
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $157.66	Professional		$123.80	$123.80	$157.66
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 $123.80 / $123.80 / $185.70	Professional		$123.80	$123.80	$185.70