Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.76 / $2,920.00 / $7,632.44	Facility		$77.76	$2,920.00	$7,632.44
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,154.04 / $1,154.04 / $10,686.00	Facility	50	$1,154.04	$1,154.04	$10,686.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.85 / $79.90 / $178.97	Professional		$49.85	$79.90	$178.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $109.71 / $201.03 / $470.90	Professional	50	$109.71	$201.03	$470.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $41.77 / $41.77 / $41.77	Professional		$41.77	$41.77	$41.77
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $126.40 / $126.40 / $126.40	Professional	50	$126.40	$126.40	$126.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $3,373.00 / $4,707.00	Facility		$1,689.00	$3,373.00	$4,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.31 / $95.10 / $192.99	Professional		$74.31	$95.10	$192.99
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $115.80 / $145.52 / $292.35	Professional	50	$115.80	$145.52	$292.35
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $74.94 / $74.94 / $6,213.00	Facility		$74.94	$74.94	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $74.94 / $74.94 / $125.07	Professional		$74.94	$74.94	$125.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.02 / $89.02 / $14,648.00	Facility		$89.02	$89.02	$14,648.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.83 / $106.84 / $251.85	Professional		$55.83	$106.84	$251.85
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $54.55 / $87.52 / $332.00	Facility		$54.55	$87.52	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $95.34 / $135.85 / $199.62	Professional		$95.34	$135.85	$199.62
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.62 / $83.62 / $83.62	Facility		$83.62	$83.62	$83.62
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.41 / $107.96 / $190.44	Professional		$73.41	$107.96	$190.44
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $153.36 / $153.36 / $1,064.05	Facility		$153.36	$153.36	$1,064.05
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.62 / $116.33 / $119.42	Professional		$83.62	$116.33	$119.42
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $132.90 / $177.18 / $228.36	Professional	50	$132.90	$177.18	$228.36
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $89.02 / $555.00 / $597.00	Facility		$89.02	$555.00	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $57.23 / $111.24 / $247.22	Professional		$57.23	$111.24	$247.22
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.00 / $3,496.00 / $6,201.00	Facility		$1,348.00	$3,496.00	$6,201.00
United Facility/Professional Professional Modifier Low / Median / High Price $74.77 / $103.94 / $260.64	Professional		$74.77	$103.94	$260.64
Univera Facility/Professional Facility Modifier Low / Median / High Price $62.15 / $62.15 / $124.65	Facility		$62.15	$62.15	$124.65
Univera Facility/Professional Professional Modifier Low / Median / High Price $74.68 / $116.53 / $190.44	Professional		$74.68	$116.53	$190.44