Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.67 / $865.44 / $7,028.00	Facility		$58.67	$865.44	$7,028.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.71 / $93.23 / $213.07	Professional		$34.71	$93.23	$213.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.69 / $95.78 / $196.82	Professional		$77.69	$95.78	$196.82
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 $39.93 / $107.42 / $214.92	Professional		$39.93	$107.42	$214.92
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $53.02 / $53.02 / $4,050.00	Facility		$53.02	$53.02	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $53.02 / $53.02 / $146.60	Professional		$53.02	$53.02	$146.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.42 / $63.42 / $14,648.00	Facility		$63.42	$63.42	$14,648.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.13 / $88.52 / $202.57	Professional		$39.13	$88.52	$202.57
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $25.14 / $49.07 / $332.00	Facility		$25.14	$49.07	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $115.42 / $133.79 / $280.07	Professional		$115.42	$133.79	$280.07
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.61 / $92.93 / $185.31	Professional		$81.61	$92.93	$185.31
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $351.47 / $810.38	Facility		$50.00	$351.47	$810.38
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.56 / $108.14 / $123.55	Professional		$47.56	$108.14	$123.55
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $63.42 / $555.00 / $74,999.25	Facility		$63.42	$555.00	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $45.02 / $116.55 / $234.88	Professional		$45.02	$116.55	$234.88
United Facility/Professional Facility Modifier Low / Median / High Price $1,101.00 / $2,930.00 / $4,761.00	Facility		$1,101.00	$2,930.00	$4,761.00
United Facility/Professional Professional Modifier Low / Median / High Price $67.00 / $113.39 / $250.08	Professional		$67.00	$113.39	$250.08
Univera Facility/Professional Facility Modifier Low / Median / High Price $40.36 / $40.36 / $51.08	Facility		$40.36	$40.36	$51.08
Univera Facility/Professional Professional Modifier Low / Median / High Price $54.07 / $99.10 / $211.72	Professional		$54.07	$99.10	$211.72