Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,765.96 / $7,028.00 / $39,109.00	Facility		$1,765.96	$7,028.00	$39,109.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,284.56 / $1,555.00 / $5,510.00	Professional		$1,284.56	$1,555.00	$5,510.00
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $38.04 / $229.90 / $389.76	Professional	AS	$38.04	$229.90	$389.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $914.27 / $1,306.09 / $2,155.38	Professional		$914.27	$1,306.09	$2,155.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,793.00 / $10,898.00 / $20,193.00	Facility		$4,793.00	$10,898.00	$20,193.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,287.51 / $1,683.02 / $3,760.53	Professional		$1,287.51	$1,683.02	$3,760.53
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $180.25 / $235.62 / $523.14	Professional	AS	$180.25	$235.62	$523.14
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $2,043.94 / $2,043.94 / $13,477.50	Facility		$2,043.94	$2,043.94	$13,477.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $2,043.94 / $2,043.94 / $2,043.94	Professional		$2,043.94	$2,043.94	$2,043.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,636.45 / $1,636.45 / $45,433.00	Facility		$1,636.45	$1,636.45	$45,433.00
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $161.91 / $161.91 / $161.91	Facility	AS	$161.91	$161.91	$161.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,443.38 / $2,267.32 / $5,603.38	Professional		$1,443.38	$2,267.32	$5,603.38
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $2,091.00 / $8,489.45	Facility		$332.00	$2,091.00	$8,489.45
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,570.59 / $2,303.13 / $4,752.00	Professional		$1,570.59	$2,303.13	$4,752.00
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,348.72 / $1,348.72 / $1,348.72	Facility		$1,348.72	$1,348.72	$1,348.72
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,171.20 / $1,464.00 / $3,038.26	Professional		$1,171.20	$1,464.00	$3,038.26
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $7,952.11 / $18,781.89 / $35,252.22	Facility		$7,952.11	$18,781.89	$35,252.22
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,536.42 / $2,036.24 / $2,620.87	Professional		$1,536.42	$2,036.24	$2,620.87
Highmark BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $208.95 / $276.92 / $276.93	Professional	AS	$208.95	$276.92	$276.93
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $1,636.45 / $45,433.00	Facility		$555.00	$1,636.45	$45,433.00
MVP Health Care Facility/Professional Facility Modifier AS Low / Median / High Price $161.91 / $161.91 / $161.91	Facility	AS	$161.91	$161.91	$161.91
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $1,509.84 / $2,190.02 / $5,500.00	Professional		$1,509.84	$2,190.02	$5,500.00
United Facility/Professional Facility Modifier Low / Median / High Price $2,673.00 / $10,317.00 / $20,972.00	Facility		$2,673.00	$10,317.00	$20,972.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,337.08 / $1,869.48 / $5,192.99	Professional		$1,337.08	$1,869.48	$5,192.99
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,722.35 / $1,722.35 / $6,858.42	Facility		$1,722.35	$1,722.35	$6,858.42
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,284.43 / $1,879.58 / $3,640.77	Professional		$1,284.43	$1,879.58	$3,640.77