Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $8,709.64 / $51,286.14	Facility		$1,621.81	$8,709.64	$51,286.14
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $22,908.68 / $22,908.68 / $22,908.68	Facility	22	$22,908.68	$22,908.68	$22,908.68
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,786.30 / $6,918.31 / $70,794.58	Facility	50	$4,786.30	$6,918.31	$70,794.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $954.99 / $1,905.46 / $8,511.38	Professional		$954.99	$1,905.46	$8,511.38
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $169.82 / $331.13 / $851.14	Professional	AS	$169.82	$331.13	$851.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $1,348.96	Professional		$165.96	$173.78	$1,348.96
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,011.87 / $14,791.08 / $63,095.73	Facility		$5,011.87	$14,791.08	$63,095.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,230.27 / $1,548.82 / $4,365.16	Professional		$1,230.27	$1,548.82	$4,365.16
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $165.96 / $208.93 / $549.54	Professional	AS	$165.96	$208.93	$549.54
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $2,630.27 / $7,943.28	Facility		$1,819.70	$2,630.27	$7,943.28
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,819.70 / $1,819.70	Professional		$1,819.70	$1,819.70	$1,819.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,187.76 / $43,651.58 / $52,480.75	Facility		$2,187.76	$43,651.58	$52,480.75
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $2,630.27 / $2,630.27 / $2,630.27	Facility	22	$2,630.27	$2,630.27	$2,630.27
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $1,513.56 / $1,513.56 / $1,513.56	Facility	54	$1,513.56	$1,513.56	$1,513.56
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $218.78 / $218.78 / $218.78	Facility	AS	$218.78	$218.78	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $2,187.76 / $7,413.10	Professional		$1,288.25	$2,187.76	$7,413.10
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $2,187.76 / $8,912.51	Facility		$1,412.54	$2,187.76	$8,912.51
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,862.09 / $3,548.13	Professional		$1,348.96	$1,862.09	$3,548.13
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,202.26 / $1,202.26 / $1,202.26	Facility		$1,202.26	$1,202.26	$1,202.26
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $954.99 / $954.99 / $954.99	Facility	54	$954.99	$954.99	$954.99
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,659.59 / $2,691.53	Professional		$1,174.90	$1,659.59	$2,691.53
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,467.37 / $15,488.17 / $25,118.86	Facility		$3,467.37	$15,488.17	$25,118.86
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $10,232.93 / $10,232.93 / $26,302.68	Facility	50	$10,232.93	$10,232.93	$26,302.68
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,778.28 / $3,981.07	Professional		$1,380.38	$1,778.28	$3,981.07
Highmark BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $239.88 / $512.86 / $549.54	Professional	AS	$239.88	$512.86	$549.54
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $50,118.72 / $75,857.76	Facility		$1,621.81	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $1,778.28 / $2,884.03	Professional		$398.11	$1,778.28	$2,884.03
United Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $12,302.69 / $40,738.03	Facility		$2,691.53	$12,302.69	$40,738.03
United Facility/Professional Professional Modifier Low / Median / High Price $1,174.90 / $1,659.59 / $4,365.16	Professional		$1,174.90	$1,659.59	$4,365.16
Univera Facility/Professional Facility Modifier Low / Median / High Price $1,047.13 / $1,513.56 / $6,918.31	Facility		$1,047.13	$1,513.56	$6,918.31
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $812.83 / $1,000.00 / $1,202.26	Facility	54	$812.83	$1,000.00	$1,202.26
Univera Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,621.81 / $3,890.45	Professional		$1,148.15	$1,621.81	$3,890.45