Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $797.73 / $3,414.00 / $10,152.00	Facility		$797.73	$3,414.00	$10,152.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.97 / $824.75 / $2,615.13	Professional		$549.97	$824.75	$2,615.13
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $585.26 / $585.26 / $585.26	Professional		$585.26	$585.26	$585.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,749.00 / $9,877.00 / $16,490.00	Facility		$4,749.00	$9,877.00	$16,490.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $808.89 / $1,040.00 / $2,125.62	Professional		$808.89	$1,040.00	$2,125.62
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $851.48 / $1,990.00 / $8,917.50	Facility		$851.48	$1,990.00	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $851.48 / $851.48 / $1,501.29	Professional		$851.48	$851.48	$1,501.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,021.88 / $1,021.88 / $1,021.88	Facility		$1,021.88	$1,021.88	$1,021.88
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $102.19 / $102.19 / $102.19	Facility	AS	$102.19	$102.19	$102.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $622.86 / $1,196.53 / $3,241.93	Professional		$622.86	$1,196.53	$3,241.93
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $990.00 / $2,029.50	Facility		$332.00	$990.00	$2,029.50
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,087.85 / $1,465.90 / $2,230.56	Professional		$1,087.85	$1,465.90	$2,230.56
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $934.18 / $934.18 / $934.18	Facility		$934.18	$934.18	$934.18
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $678.80 / $1,220.58 / $2,153.15	Professional		$678.80	$1,220.58	$2,153.15
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,740.63 / $5,266.27 / $29,061.12	Facility		$1,740.63	$5,266.27	$29,061.12
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $643.34 / $855.74 / $1,419.45	Professional		$643.34	$855.74	$1,419.45
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $1,021.88	Facility		$555.00	$597.00	$1,021.88
MVP Health Care Facility/Professional Facility Modifier AS Low / Median / High Price $102.19 / $102.19 / $102.19	Facility	AS	$102.19	$102.19	$102.19
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $697.85 / $1,317.29 / $3,074.55	Professional		$697.85	$1,317.29	$3,074.55
United Facility/Professional Facility Modifier Low / Median / High Price $2,264.00 / $5,248.00 / $11,200.00	Facility		$2,264.00	$5,248.00	$11,200.00
United Facility/Professional Professional Modifier Low / Median / High Price $888.64 / $1,311.35 / $3,307.14	Professional		$888.64	$1,311.35	$3,307.14
Univera Facility/Professional Facility Modifier Low / Median / High Price $727.79 / $727.79 / $2,947.20	Facility		$727.79	$727.79	$2,947.20
Univera Facility/Professional Professional Modifier Low / Median / High Price $727.79 / $1,301.86 / $2,153.15	Professional		$727.79	$1,301.86	$2,153.15