Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $81.28 / $112.20	Professional		$42.66	$81.28	$112.20
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Professional		$128.82	$128.82	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Facility		$186.21	$186.21	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $46.77	Professional		$46.77	$46.77	$46.77
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $190.55 / $288.40	Professional		$144.54	$190.55	$288.40
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $131.83	Facility		$131.83	$131.83	$131.83
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $102.33 / $131.83	Professional		$79.43	$102.33	$131.83
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $81.28 / $112.20	Professional		$41.69	$81.28	$112.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $0.60 / $0.60 / $0.60	Professional		$0.60	$0.60	$0.60
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $93.33 / $125.89	Professional		$89.13	$93.33	$125.89
United Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Facility		$158.49	$158.49	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $64.57 / $100.00	Professional		$48.98	$64.57	$100.00