Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.17 / $1,575.60 / $6,962.00	Facility		$113.17	$1,575.60	$6,962.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $61.94 / $99.31 / $143.90	Facility	54	$61.94	$99.31	$143.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.58 / $128.00 / $346.32	Professional		$82.58	$128.00	$346.32
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $119.16 / $119.16 / $124.51	Professional		$119.16	$119.16	$124.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,691.00 / $3,382.00 / $4,707.00	Facility		$1,691.00	$3,382.00	$4,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.41 / $107.03 / $244.32	Professional		$84.41	$107.03	$244.32
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $145.13 / $145.13 / $4,050.00	Facility		$145.13	$145.13	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $145.13 / $145.13 / $174.26	Professional		$145.13	$145.13	$174.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $178.33 / $178.33 / $14,648.00	Facility		$178.33	$178.33	$14,648.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $124.83 / $124.83 / $124.83	Facility	54	$124.83	$124.83	$124.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.50 / $148.91 / $371.34	Professional		$84.50	$148.91	$371.34
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $72.00 / $140.78 / $332.00	Facility		$72.00	$140.78	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $11.04 / $94.82 / $268.48	Professional		$11.04	$94.82	$268.48
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.23 / $118.98 / $235.69	Professional		$88.23	$118.98	$235.69
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $128.61 / $128.61 / $128.61	Professional		$128.61	$128.61	$128.61
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $175.11 / $373.99 / $1,587.75	Facility		$175.11	$373.99	$1,587.75
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.91 / $142.91 / $213.76	Professional		$125.91	$142.91	$213.76
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $178.33 / $555.00 / $74,999.25	Facility		$178.33	$555.00	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $124.83 / $124.83 / $124.83	Facility	54	$124.83	$124.83	$124.83
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $86.74 / $156.36 / $371.34	Professional		$86.74	$156.36	$371.34
United Facility/Professional Facility Modifier Low / Median / High Price $1,252.00 / $2,651.00 / $4,592.00	Facility		$1,252.00	$2,651.00	$4,592.00
United Facility/Professional Professional Modifier Low / Median / High Price $80.70 / $142.90 / $311.29	Professional		$80.70	$142.90	$311.29
Univera Facility/Professional Facility Modifier Low / Median / High Price $115.33 / $115.33 / $302.89	Facility		$115.33	$115.33	$302.89
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $103.80 / $103.80 / $103.80	Facility	54	$103.80	$103.80	$103.80
Univera Facility/Professional Professional Modifier Low / Median / High Price $88.23 / $126.04 / $300.42	Professional		$88.23	$126.04	$300.42