Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $645.00 / $4,392.00 / $10,081.00	Facility		$645.00	$4,392.00	$10,081.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $464.53 / $573.52 / $1,486.16	Professional		$464.53	$573.52	$1,486.16
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $586.79 / $586.79 / $713.68	Professional		$586.79	$586.79	$713.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,385.00 / $4,133.00 / $9,074.00	Facility		$2,385.00	$4,133.00	$9,074.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $449.40 / $587.46 / $1,306.27	Professional		$449.40	$587.46	$1,306.27
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $743.41 / $1,716.00 / $6,213.00	Facility		$743.41	$1,716.00	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $743.41 / $743.41 / $743.41	Professional		$743.41	$743.41	$743.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $604.47 / $604.47 / $604.47	Facility		$604.47	$604.47	$604.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $512.52 / $793.16 / $2,067.41	Professional		$512.52	$793.16	$2,067.41
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $282.00 / $521.60 / $1,418.18	Facility		$282.00	$521.60	$1,418.18
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $583.53 / $824.63 / $1,216.48	Professional		$583.53	$824.63	$1,216.48
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $501.10 / $501.10 / $501.10	Facility		$501.10	$501.10	$501.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $403.51 / $805.60 / $1,223.60	Professional		$403.51	$805.60	$1,223.60
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,716.09 / $2,716.09 / $2,716.09	Facility		$2,716.09	$2,716.09	$2,716.09
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $705.10 / $736.98 / $951.66	Professional		$705.10	$736.98	$951.66
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $604.47	Facility		$555.00	$597.00	$604.47
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $535.76 / $793.16 / $1,908.66	Professional		$535.76	$793.16	$1,908.66
United Facility/Professional Facility Modifier Low / Median / High Price $1,768.00 / $3,961.00 / $8,312.00	Facility		$1,768.00	$3,961.00	$8,312.00
United Facility/Professional Professional Modifier Low / Median / High Price $467.39 / $670.96 / $1,831.11	Professional		$467.39	$670.96	$1,831.11
Univera Facility/Professional Facility Modifier Low / Median / High Price $636.70 / $636.70 / $2,163.64	Facility		$636.70	$636.70	$2,163.64
Univera Facility/Professional Professional Modifier Low / Median / High Price $432.95 / $805.60 / $1,368.56	Professional		$432.95	$805.60	$1,368.56