Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $67.61 / $104.71	Facility		$31.62	$67.61	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.85 / $19.95 / $26.92	Professional		$15.85	$19.95	$26.92
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 $19.50 / $19.50 / $46.77	Professional		$19.50	$19.50	$46.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $40.74 / $87.10	Facility		$24.55	$40.74	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $25.12 / $25.12	Professional		$25.12	$25.12	$25.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $33.88 / $36.31	Professional		$26.30	$33.88	$36.31
Geisinger Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $25.12 / $25.12	Facility		$25.12	$25.12	$25.12
Geisinger Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $35.48 / $44.67	Professional		$20.89	$35.48	$44.67
Martin's Point Facility/Professional Facility Modifier Low / Median / High Price $31.62 / $63.10 / $104.71	Facility		$31.62	$63.10	$104.71
Martin's Point Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $19.95 / $44.67	Professional		$18.20	$19.95	$44.67
UPMC Health Plan Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $30.90 / $30.90	Facility		$25.12	$30.90	$30.90
UPMC Health Plan Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $30.90 / $114.82	Professional		$18.20	$30.90	$114.82
United Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $25.12 / $30.20	Facility		$25.12	$25.12	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $15.14 / $31.62	Professional		$10.47	$15.14	$31.62