Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $133.22 / $377.15	Facility		$131.90	$133.22	$377.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $135.86	Professional		$131.90	$131.90	$135.86
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $112.60 / $131.90 / $8,639.91	Facility		$112.60	$131.90	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $131.90	Professional		$131.90	$131.90	$131.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $131.90 / $131.90	Facility		$131.90	$131.90	$131.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $143.10	Professional		$131.90	$131.90	$143.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $130.65 / $136.87 / $228.12	Professional		$130.65	$136.87	$228.12
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $131.90 / $144.29 / $377.15	Facility		$131.90	$144.29	$377.15
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $171.71	Professional		$131.90	$131.90	$171.71
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $124.43 / $131.90 / $131.90	Facility		$124.43	$131.90	$131.90
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $149.32	Professional		$131.90	$131.90	$149.32
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $158.16 / $158.16 / $183.54	Facility		$158.16	$158.16	$183.54
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $158.16 / $158.16 / $183.54	Professional		$158.16	$158.16	$183.54
United Facility/Professional Professional Modifier Low / Median / High Price $131.90 / $131.90 / $197.85	Professional		$131.90	$131.90	$197.85