Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $81.28 / $128.82	Facility		$36.31	$81.28	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $22.91 / $33.88	Professional		$19.05	$22.91	$33.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $14.79 / $14.79	Professional		$14.79	$14.79	$14.79
Capital Blue Cross Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $8,511.38 / $77,624.71	Facility		$5,011.87	$8,511.38	$77,624.71
Capital Blue Cross Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $22.91 / $53.70	Professional		$22.91	$22.91	$53.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $47.86 / $100.00	Facility		$28.84	$47.86	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $141.25 / $141.25	Professional		$141.25	$141.25	$141.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $39.81 / $64.57	Professional		$30.90	$39.81	$64.57
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $29.51 / $29.51	Facility		$29.51	$29.51	$29.51
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $35.48 / $61.66	Professional		$24.55	$35.48	$61.66
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $75.86 / $123.03	Facility		$34.67	$75.86	$123.03
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $23.99 / $87.10	Professional		$19.05	$23.99	$87.10
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $30.90 / $36.31	Facility		$29.51	$30.90	$36.31
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $30.90 / $36.31	Professional		$29.51	$30.90	$36.31
United Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $29.51 / $35.48	Facility		$29.51	$29.51	$35.48
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $17.78 / $39.81	Professional		$12.30	$17.78	$39.81