Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $99.53 / $101.03 / $260.14	Facility		$99.53	$101.03	$260.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $127.29	Professional		$101.03	$101.03	$127.29
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $86.25 / $101.03 / $8,639.91	Facility		$86.25	$101.03	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $101.03	Professional		$101.03	$101.03	$101.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $101.03 / $101.03 / $101.03	Facility		$101.03	$101.03	$101.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $109.61	Professional		$101.03	$101.03	$109.61
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $85.88 / $101.03 / $129.05	Professional		$85.88	$101.03	$129.05
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $99.53 / $101.03 / $260.14	Facility		$99.53	$101.03	$260.14
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $127.29	Professional		$101.03	$101.03	$127.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $204.70 / $249.00 / $249.00	Professional		$204.70	$249.00	$249.00
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $95.31 / $101.03 / $101.03	Facility		$95.31	$101.03	$101.03
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $114.37	Professional		$101.03	$101.03	$114.37
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $109.76 / $109.76 / $127.36	Facility		$109.76	$109.76	$127.36
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $109.76 / $109.76 / $127.36	Professional		$109.76	$109.76	$127.36
United Facility/Professional Professional Modifier Low / Median / High Price $101.03 / $101.03 / $174.13	Professional		$101.03	$101.03	$174.13