Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $524.81 / $870.96	Facility		$338.84	$524.81	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $50.12 / $724.44	Professional		$30.20	$50.12	$724.44
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $147.91 / $912.01 / $1,230.27	Professional	AA	$147.91	$912.01	$1,230.27
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $239.88 / $478.63 / $575.44	Professional	QX	$239.88	$478.63	$575.44
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $70.79 / $489.78 / $616.60	Professional	QY	$70.79	$489.78	$616.60
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $131.83 / $346.74 / $1,122.02	Professional	QZ	$131.83	$346.74	$1,122.02
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	QX	$229.09	$229.09	$229.09
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	QY	$229.09	$229.09	$229.09
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $123.03 / $144.54 / $144.54	Professional	QZ	$123.03	$144.54	$144.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $478.63 / $758.58	Professional		$302.00	$478.63	$758.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $53,703.18	Facility		$61.66	$61.66	$53,703.18
Cigna Facility/Professional Facility Modifier QK Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QK	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QX Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QX	$30.90	$30.90	$30.90
Cigna Facility/Professional Facility Modifier QY Low / Median / High Price $30.90 / $30.90 / $30.90	Facility	QY	$30.90	$30.90	$30.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $489.78 / $776.25	Professional		$275.42	$489.78	$776.25
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $457.09 / $660.69	Professional		$117.49	$457.09	$660.69
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $354.81 / $478.63	Professional		$83.18	$354.81	$478.63
Highmark BCBS Facility/Professional Professional Modifier QX Low / Median / High Price $645.65 / $741.31 / $851.14	Professional	QX	$645.65	$741.31	$851.14
Highmark BCBS Facility/Professional Professional Modifier QZ Low / Median / High Price $537.03 / $537.03 / $537.03	Professional	QZ	$537.03	$537.03	$537.03
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $50,118.72 / $53,703.18 / $75,857.76	Facility		$50,118.72	$53,703.18	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $630.96 / $776.25	Professional		$302.00	$630.96	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $75.86 / $120.23	Professional		$50.12	$75.86	$120.23
Univera Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $102.33 / $218.78	Facility		$102.33	$102.33	$218.78
Univera Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $338.84 / $478.63	Professional		$93.33	$338.84	$478.63