Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.83 / $1,918.53 / $7,632.44	Facility		$102.83	$1,918.53	$7,632.44
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $30.26 / $54.02 / $59.99	Facility	52	$30.26	$54.02	$59.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.71 / $115.65 / $281.89	Professional		$63.71	$115.65	$281.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.14 / $123.14 / $123.14	Professional		$123.14	$123.14	$123.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,691.00 / $3,333.00 / $4,636.00	Facility		$1,691.00	$3,333.00	$4,636.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.24 / $149.97 / $321.52	Professional		$120.24	$149.97	$321.52
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $102.50 / $102.50 / $4,050.00	Facility		$102.50	$102.50	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $102.50 / $102.50 / $192.27	Professional		$102.50	$102.50	$192.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $124.29 / $124.29 / $3,479.91	Facility		$124.29	$124.29	$3,479.91
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $99.43 / $99.43 / $99.43	Facility	52	$99.43	$99.43	$99.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.51 / $173.71 / $425.68	Professional		$83.51	$173.71	$425.68
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $45.29 / $92.84 / $332.00	Facility		$45.29	$92.84	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $136.96 / $179.47 / $268.58	Professional		$136.96	$179.47	$268.58
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.34 / $125.13 / $248.26	Professional		$109.34	$125.13	$248.26
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $134.52 / $134.52 / $136.96	Professional		$134.52	$134.52	$136.96
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $659.95 / $1,190.88 / $2,826.00	Facility		$659.95	$1,190.88	$2,826.00
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $1,421.78 / $1,421.78 / $1,429.25	Facility	52	$1,421.78	$1,421.78	$1,429.25
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $124.29 / $555.00 / $3,479.91	Facility		$124.29	$555.00	$3,479.91
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $99.43 / $99.43 / $99.43	Facility	52	$99.43	$99.43	$99.43
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $91.60 / $176.57 / $414.74	Professional		$91.60	$176.57	$414.74
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.00 / $3,496.00 / $5,963.00	Facility		$1,348.00	$3,496.00	$5,963.00
United Facility/Professional Professional Modifier Low / Median / High Price $89.38 / $159.13 / $351.85	Professional		$89.38	$159.13	$351.85
Univera Facility/Professional Facility Modifier Low / Median / High Price $78.00 / $78.00 / $78.00	Facility		$78.00	$78.00	$78.00
Univera Facility/Professional Professional Modifier Low / Median / High Price $109.34 / $132.76 / $269.85	Professional		$109.34	$132.76	$269.85