Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $204.96 / $207.00 / $620.85	Facility		$204.96	$207.00	$620.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $207.00	Professional		$204.96	$204.96	$207.00
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $174.97 / $204.96 / $8,639.91	Facility		$174.97	$204.96	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $204.96	Professional		$204.96	$204.96	$204.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.96 / $204.96 / $204.96	Facility		$204.96	$204.96	$204.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $232.02	Professional		$204.96	$204.96	$232.02
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $203.02 / $212.69 / $354.48	Professional		$203.02	$212.69	$354.48
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $204.96 / $237.52 / $620.85	Facility		$204.96	$237.52	$620.85
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $237.52	Professional		$204.96	$204.96	$237.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $176.10 / $200.50 / $1,205.09	Professional		$176.10	$200.50	$1,205.09
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $193.35 / $204.96 / $204.96	Facility		$193.35	$204.96	$204.96
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $261.02	Professional		$204.96	$204.96	$261.02
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $460.50 / $460.50 / $534.35	Facility		$460.50	$460.50	$534.35
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $460.50 / $460.50 / $534.35	Professional		$460.50	$460.50	$534.35
United Facility/Professional Professional Modifier Low / Median / High Price $204.96 / $204.96 / $353.25	Professional		$204.96	$204.96	$353.25