Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $564.73 / $4,260.00 / $10,965.00	Facility		$564.73	$4,260.00	$10,965.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.35 / $469.61 / $925.73	Professional		$398.35	$469.61	$925.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $690.42 / $690.42 / $690.42	Professional		$690.42	$690.42	$690.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,248.00 / $5,196.00 / $11,909.00	Facility		$3,248.00	$5,196.00	$11,909.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $358.88 / $466.48 / $1,084.85	Professional		$358.88	$466.48	$1,084.85
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $636.15 / $636.15 / $16,534.50	Facility		$636.15	$636.15	$16,534.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $636.15 / $636.15 / $636.15	Professional		$636.15	$636.15	$636.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $513.73 / $513.73 / $513.73	Facility		$513.73	$513.73	$513.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $450.44 / $671.51 / $1,656.46	Professional		$450.44	$671.51	$1,656.46
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $269.00 / $467.20 / $1,168.88	Facility		$269.00	$467.20	$1,168.88
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $495.69 / $683.65 / $1,002.64	Professional		$495.69	$683.65	$1,002.64
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $426.55 / $426.55 / $426.55	Facility		$426.55	$426.55	$426.55
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $378.55 / $463.82 / $962.57	Professional		$378.55	$463.82	$962.57
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $873.50 / $2,212.52 / $4,840.12	Facility		$873.50	$2,212.52	$4,840.12
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $645.67 / $821.52 / $830.58	Professional		$645.67	$821.52	$830.58
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $513.73 / $555.00 / $597.00	Facility		$513.73	$555.00	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $437.86 / $668.22 / $1,530.18	Professional		$437.86	$668.22	$1,530.18
United Facility/Professional Facility Modifier Low / Median / High Price $2,031.00 / $4,840.00 / $9,416.00	Facility		$2,031.00	$4,840.00	$9,416.00
United Facility/Professional Professional Modifier Low / Median / High Price $407.93 / $566.55 / $1,404.34	Professional		$407.93	$566.55	$1,404.34
Univera Facility/Professional Facility Modifier Low / Median / High Price $545.66 / $545.66 / $1,279.08	Facility		$545.66	$545.66	$1,279.08
Univera Facility/Professional Professional Modifier Low / Median / High Price $398.50 / $594.44 / $1,153.45	Professional		$398.50	$594.44	$1,153.45