Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.69 / $137.93 / $286.70	Facility		$109.69	$137.93	$286.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $139.31	Professional		$137.93	$137.93	$139.31
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $117.75 / $137.93 / $8,639.91	Facility		$117.75	$137.93	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $137.93	Professional		$137.93	$137.93	$137.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.12 / $137.93 / $137.93	Facility		$130.12	$137.93	$137.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $137.93	Professional		$137.93	$137.93	$137.93
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $117.24 / $143.13 / $238.55	Professional		$117.24	$143.13	$238.55
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $109.69 / $137.93 / $286.70	Facility		$109.69	$137.93	$286.70
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $130.53 / $137.93 / $139.31	Professional		$130.53	$137.93	$139.31
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $130.12 / $137.93 / $137.93	Facility		$130.12	$137.93	$137.93
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $138.33	Professional		$137.93	$137.93	$138.33
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $160.65 / $160.65 / $186.42	Facility		$160.65	$160.65	$186.42
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $160.65 / $160.65 / $186.42	Professional		$160.65	$160.65	$186.42
United Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $206.90	Professional		$137.93	$137.93	$206.90