Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,105.50	Facility		$4,105.50	$4,105.50	$4,105.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,864.00 / $4,105.50 / $4,105.50	Professional		$3,864.00	$4,105.50	$4,105.50
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $2,271.71 / $2,672.60 / $8,639.91	Facility		$2,271.71	$2,672.60	$8,639.91
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $2,672.60 / $2,672.60 / $2,672.60	Professional		$2,672.60	$2,672.60	$2,672.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,105.50	Facility		$4,105.50	$4,105.50	$4,105.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,105.50	Professional		$4,105.50	$4,105.50	$4,105.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,326.44 / $2,737.00 / $3,791.20	Professional		$2,326.44	$2,737.00	$3,791.20
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,105.50	Facility		$4,105.50	$4,105.50	$4,105.50
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $3,864.00 / $4,105.50 / $4,105.50	Professional		$3,864.00	$4,105.50	$4,105.50
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,105.50	Facility		$4,105.50	$4,105.50	$4,105.50
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $4,105.50 / $4,105.50 / $4,105.50	Professional		$4,105.50	$4,105.50	$4,105.50
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $2,968.00 / $2,968.00 / $3,444.00	Facility		$2,968.00	$2,968.00	$3,444.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $2,968.00 / $2,968.00 / $3,444.00	Professional		$2,968.00	$2,968.00	$3,444.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,780.00 / $4,200.00 / $5,250.00	Professional		$3,780.00	$4,200.00	$5,250.00