Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.36 / $2,345.00 / $9,038.00	Facility		$114.36	$2,345.00	$9,038.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $761.93 / $3,084.80 / $13,211.51	Facility	50	$761.93	$3,084.80	$13,211.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.66 / $165.29 / $422.73	Professional		$70.66	$165.29	$422.73
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $141.05 / $281.94 / $823.00	Professional	50	$141.05	$281.94	$823.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $209.29 / $209.29 / $209.29	Professional		$209.29	$209.29	$209.29
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $229.46 / $229.46 / $229.46	Professional	50	$229.46	$229.46	$229.46
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 $92.80 / $121.32 / $413.77	Professional		$92.80	$121.32	$413.77
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $139.21 / $178.91 / $609.07	Professional	50	$139.21	$178.91	$609.07
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $117.93 / $1,254.00 / $4,050.00	Facility		$117.93	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $117.93 / $117.93 / $234.90	Professional		$117.93	$117.93	$234.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $141.63 / $141.63 / $14,648.00	Facility		$141.63	$141.63	$14,648.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.01 / $197.36 / $534.37	Professional		$84.01	$197.36	$534.37
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $87.36 / $141.05 / $332.00	Facility		$87.36	$141.05	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $177.50 / $254.50 / $398.48	Professional		$177.50	$254.50	$398.48
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $152.41 / $152.41 / $152.41	Facility		$152.41	$152.41	$152.41
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.51 / $196.55 / $346.72	Professional		$137.51	$196.55	$346.72
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.29 / $288.00 / $1,409.95	Facility		$125.29	$288.00	$1,409.95
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $175.08 / $661.92 / $2,000.08	Facility	50	$175.08	$661.92	$2,000.08
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $118.36 / $118.36 / $227.77	Professional		$118.36	$118.36	$227.77
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $178.52 / $178.52 / $239.80	Professional	50	$178.52	$178.52	$239.80
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $141.63 / $555.00 / $597.00	Facility		$141.63	$555.00	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $94.05 / $224.90 / $549.33	Professional		$94.05	$224.90	$549.33
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 $143.68 / $212.95 / $542.63	Professional		$143.68	$212.95	$542.63
Univera Facility/Professional Facility Modifier Low / Median / High Price $99.41 / $99.41 / $327.42	Facility		$99.41	$99.41	$327.42
Univera Facility/Professional Professional Modifier Low / Median / High Price $152.41 / $210.14 / $346.72	Professional		$152.41	$210.14	$346.72