Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $110.53 / $343.49	Facility		$109.44	$110.53	$343.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $110.53	Professional		$109.44	$109.44	$110.53
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $93.43 / $109.44 / $8,639.91	Facility		$93.43	$109.44	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $109.44	Professional		$109.44	$109.44	$109.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $109.44 / $109.44	Facility		$109.44	$109.44	$109.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $118.73	Professional		$109.44	$109.44	$118.73
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $93.02 / $109.44 / $139.79	Professional		$93.02	$109.44	$139.79
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $109.44 / $131.41 / $343.49	Facility		$109.44	$131.41	$343.49
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $131.41	Professional		$109.44	$109.44	$131.41
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $103.24 / $109.44 / $109.44	Facility		$103.24	$109.44	$109.44
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $139.38	Professional		$109.44	$109.44	$139.38
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $380.65 / $380.65 / $441.69	Facility		$380.65	$380.65	$441.69
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $380.65 / $380.65 / $441.69	Professional		$380.65	$380.65	$441.69
United Facility/Professional Professional Modifier Low / Median / High Price $109.44 / $109.44 / $200.28	Professional		$109.44	$109.44	$200.28