Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.42 / $1,050.84 / $7,028.00	Facility		$67.42	$1,050.84	$7,028.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $278.22 / $580.02 / $7,872.86	Facility	50	$278.22	$580.02	$7,872.86
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $26.04 / $34.79 / $49.23	Facility	52	$26.04	$34.79	$49.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.04 / $73.76 / $239.00	Professional		$41.04	$73.76	$239.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $37.67 / $129.91 / $342.00	Professional	50	$37.67	$129.91	$342.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $40.47 / $67.41 / $96.48	Professional		$40.47	$67.41	$96.48
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $87.31 / $104.55 / $144.72	Professional	50	$87.31	$104.55	$144.72
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 $52.21 / $68.26 / $152.59	Professional		$52.21	$68.26	$152.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $78.31 / $102.39 / $227.68	Professional	50	$78.31	$102.39	$227.68
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $64.44 / $64.44 / $6,213.00	Facility		$64.44	$64.44	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $64.44 / $64.44 / $90.22	Professional		$64.44	$64.44	$90.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.04 / $77.04 / $77.04	Facility		$77.04	$77.04	$77.04
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $61.63 / $61.63 / $61.63	Facility	52	$61.63	$61.63	$61.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.09 / $83.19 / $209.75	Professional		$49.09	$83.19	$209.75
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $69.20 / $332.00	Facility		$40.00	$69.20	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $73.40 / $110.82 / $422.45	Professional		$73.40	$110.82	$422.45
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.56 / $60.56 / $60.56	Facility		$60.56	$60.56	$60.56
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.97 / $66.22 / $137.41	Professional		$52.97	$66.22	$137.41
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $46.35 / $58.11 / $65.40	Professional		$46.35	$58.11	$65.40
Fidelis Facility/Professional Professional Modifier 50 Low / Median / High Price $59.73 / $121.38 / $121.38	Professional	50	$59.73	$121.38	$121.38
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.20 / $337.35 / $1,157.99	Facility		$77.20	$337.35	$1,157.99
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $50.00 / $393.09 / $1,201.18	Facility	50	$50.00	$393.09	$1,201.18
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $81.63 / $145.00	Professional		$60.00	$81.63	$145.00
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $90.00 / $122.43 / $165.75	Professional	50	$90.00	$122.43	$165.75
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $77.04 / $555.00 / $597.00	Facility		$77.04	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $61.63 / $61.63 / $61.63	Facility	52	$61.63	$61.63	$61.63
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $53.07 / $87.81 / $209.75	Professional		$53.07	$87.81	$209.75
United Facility/Professional Facility Modifier Low / Median / High Price $964.00 / $2,826.00 / $4,851.00	Facility		$964.00	$2,826.00	$4,851.00
United Facility/Professional Professional Modifier Low / Median / High Price $54.90 / $78.08 / $186.72	Professional		$54.90	$78.08	$186.72
United Facility/Professional Professional Modifier 50 Low / Median / High Price $80.00 / $80.00 / $85.00	Professional	50	$80.00	$80.00	$85.00
Univera Facility/Professional Facility Modifier Low / Median / High Price $54.21 / $54.21 / $232.91	Facility		$54.21	$54.21	$232.91
Univera Facility/Professional Professional Modifier Low / Median / High Price $60.56 / $84.39 / $137.41	Professional		$60.56	$84.39	$137.41