Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $66.54 / $175.16	Facility		$65.88	$66.54	$175.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $66.54	Professional		$65.88	$65.88	$66.54
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $56.24 / $65.88 / $8,639.91	Facility		$56.24	$65.88	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $65.88	Professional		$65.88	$65.88	$65.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $65.88 / $65.88	Facility		$65.88	$65.88	$65.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $69.92	Professional		$65.88	$65.88	$69.92
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $65.26 / $65.88 / $89.20	Professional		$65.26	$65.88	$89.20
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $65.88 / $67.01 / $175.16	Facility		$65.88	$67.01	$175.16
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $67.01	Professional		$65.88	$65.88	$67.01
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $62.15 / $65.88 / $65.88	Facility		$62.15	$65.88	$65.88
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $65.88 / $65.88 / $83.77	Professional		$65.88	$65.88	$83.77
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 $65.88 / $65.88 / $110.14	Professional		$65.88	$65.88	$110.14