Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $662.69 / $2,877.78	Facility		$656.12	$662.69	$2,877.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $662.69	Professional		$656.12	$656.12	$662.69
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $560.13 / $656.12 / $8,639.91	Facility		$560.13	$656.12	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $656.12	Professional		$656.12	$656.12	$656.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $656.12 / $656.12	Facility		$656.12	$656.12	$656.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $680.88	Professional		$656.12	$656.12	$680.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $649.92 / $680.88 / $838.10	Professional		$649.92	$680.88	$838.10
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $656.12 / $1,100.97 / $2,877.78	Facility		$656.12	$1,100.97	$2,877.78
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $1,100.97	Professional		$656.12	$656.12	$1,100.97
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $618.98 / $656.12 / $656.12	Facility		$618.98	$656.12	$656.12
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $835.63	Professional		$656.12	$656.12	$835.63
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $166.13 / $166.13 / $192.77	Facility		$166.13	$166.13	$192.77
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $166.13 / $166.13 / $192.77	Professional		$166.13	$166.13	$192.77
United Facility/Professional Professional Modifier Low / Median / High Price $656.12 / $656.12 / $984.18	Professional		$656.12	$656.12	$984.18