Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $128.82 / $12,589.25	Facility		$56.23	$128.82	$12,589.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $77.62	Professional		$54.95	$54.95	$77.62
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $58.88 / $5,011.87	Facility		$50.12	$58.88	$5,011.87
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $56.23	Professional		$56.23	$56.23	$56.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Professional		$54.95	$54.95	$54.95
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $57.54 / $79.43	Professional		$48.98	$57.54	$79.43
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $72.44 / $109.65	Professional		$54.95	$72.44	$109.65
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $123.03 / $12,302.69	Facility		$56.23	$123.03	$12,302.69
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $56.23 / $102.33	Professional		$54.95	$56.23	$102.33
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $30.20 / $109.65	Professional		$0.60	$30.20	$109.65
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $42.66 / $81.28	Facility		$36.31	$42.66	$81.28
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $45.71 / $81.28	Professional		$33.11	$45.71	$81.28
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $54.95 / $54.95	Facility		$54.95	$54.95	$54.95
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $58.88 / $74.13	Professional		$54.95	$58.88	$74.13