Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.81 / $468.00 / $876.00	Facility		$33.81	$468.00	$876.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $42.00 / $606.00	Professional		$30.00	$42.00	$606.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $149.33 / $1,002.00 / $1,269.59	Professional	AA	$149.33	$1,002.00	$1,269.59
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $534.40 / $542.75 / $609.54	Professional	QX	$534.40	$542.75	$609.54
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $71.44 / $601.20 / $672.30	Professional	QY	$71.44	$601.20	$672.30
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $139.54 / $935.20 / $1,887.10	Professional	QZ	$139.54	$935.20	$1,887.10
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $143.36 / $143.36 / $143.36	Professional	QZ	$143.36	$143.36	$143.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $195.78 / $480.00 / $750.00	Professional		$195.78	$480.00	$750.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $290.00 / $495.00 / $757.05	Professional		$290.00	$495.00	$757.05
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $450.00 / $450.00	Facility		$450.00	$450.00	$450.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $124.08 / $480.00 / $727.68	Professional		$124.08	$480.00	$727.68
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $350.00 / $479.25	Professional		$84.00	$350.00	$479.25
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $625.40 / $720.80 / $853.20	Professional	QX	$625.40	$720.80	$853.20
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $537.83 / $537.83 / $545.40	Professional	QZ	$537.83	$537.83	$545.40
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $74,999.25	Facility		$555.00	$597.00	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $285.00 / $500.00 / $770.34	Professional		$285.00	$500.00	$770.34
MVP Health Care Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
MVP Health Care Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00
United Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $74.23 / $118.00	Professional		$50.00	$74.23	$118.00
Univera Facility/Professional Facility Modifier Low / Median / High Price $220.00 / $220.00 / $220.00	Facility		$220.00	$220.00	$220.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $98.95 / $355.00 / $530.25	Professional		$98.95	$355.00	$530.25