Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $3,264.00 / $3,264.00 / $4,667.52	Facility		$3,264.00	$3,264.00	$4,667.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,072.00 / $3,264.00 / $3,264.00	Professional		$3,072.00	$3,264.00	$3,264.00
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $634.39 / $743.11 / $8,459.92	Facility		$634.39	$743.11	$8,459.92
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $743.11 / $743.11 / $743.11	Professional		$743.11	$743.11	$743.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,264.00 / $3,264.00 / $3,366.00	Facility		$3,264.00	$3,264.00	$3,366.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3,264.00 / $3,264.00 / $3,264.00	Professional		$3,264.00	$3,264.00	$3,264.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $3,564.00 / $3,564.00 / $3,564.00	Professional		$3,564.00	$3,564.00	$3,564.00
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $3,264.00 / $3,264.00 / $4,667.52	Facility		$3,264.00	$3,264.00	$4,667.52
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $3,072.00 / $3,264.00 / $3,264.00	Professional		$3,072.00	$3,264.00	$3,264.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3,846.43 / $7,169.83 / $11,566.32	Professional		$3,846.43	$7,169.83	$11,566.32
Priority Health Facility/Professional Facility Modifier Low / Median / High Price $3,264.00 / $3,264.00 / $3,366.00	Facility		$3,264.00	$3,264.00	$3,366.00
Priority Health Facility/Professional Professional Modifier Low / Median / High Price $3,264.00 / $3,264.00 / $3,264.00	Professional		$3,264.00	$3,264.00	$3,264.00
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $3,960.00 / $3,960.00 / $4,356.00	Facility		$3,960.00	$3,960.00	$4,356.00
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $3,960.00 / $3,960.00 / $4,356.00	Professional		$3,960.00	$3,960.00	$4,356.00
United Facility/Professional Professional Modifier Low / Median / High Price $3,200.00 / $3,200.00 / $4,176.00	Professional		$3,200.00	$3,200.00	$4,176.00