Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $54.95 / $74.13	Professional		$28.84	$54.95	$74.13
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $87.10	Professional		$87.10	$87.10	$87.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Facility		$120.23	$120.23	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $32.36	Professional		$32.36	$32.36	$32.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $131.83 / $194.98	Professional		$100.00	$131.83	$194.98
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $89.13	Facility		$89.13	$89.13	$89.13
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $69.18 / $89.13	Professional		$53.70	$69.18	$89.13
Independence Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $53.70 / $75.86	Professional		$28.84	$53.70	$75.86
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $34.67 / $39.81	Professional		$0.60	$34.67	$39.81
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $61.66 / $309.03	Professional		$39.81	$61.66	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $43.65 / $61.66	Professional		$29.51	$43.65	$61.66