Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.29 / $87.98 / $212.47	Facility		$81.29	$87.98	$212.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $88.86	Professional		$87.98	$87.98	$88.86
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $74.78 / $87.98 / $131.97	Facility		$74.78	$87.98	$131.97
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $87.98	Professional		$87.98	$87.98	$87.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.98 / $87.98 / $87.98	Facility		$87.98	$87.98	$87.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $87.98	Professional		$87.98	$87.98	$87.98
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $74.78 / $87.98 / $112.38	Professional		$74.78	$87.98	$112.38
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $81.29 / $87.98 / $212.47	Facility		$81.29	$87.98	$212.47
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $88.86	Professional		$87.98	$87.98	$88.86
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $83.00 / $87.98 / $87.98	Facility		$83.00	$87.98	$87.98
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $91.30	Professional		$87.98	$87.98	$91.30
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $150.55 / $150.55 / $174.69	Facility		$150.55	$150.55	$174.69
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $150.55 / $150.55 / $174.69	Professional		$150.55	$150.55	$174.69
United Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $114.81	Professional		$87.98	$87.98	$114.81