Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $904.50 / $5,630.00 / $12,075.00	Facility		$904.50	$5,630.00	$12,075.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $601.22 / $904.50 / $2,089.23	Professional		$601.22	$904.50	$2,089.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $582.71 / $582.71 / $582.71	Professional		$582.71	$582.71	$582.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,464.00 / $7,631.00 / $14,193.00	Facility		$4,464.00	$7,631.00	$14,193.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $802.76 / $1,036.98 / $2,105.46	Professional		$802.76	$1,036.98	$2,105.46
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $827.29 / $2,644.00 / $12,319.50	Facility		$827.29	$2,644.00	$12,319.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $827.29 / $827.29 / $1,451.80	Professional		$827.29	$827.29	$1,451.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,018.68 / $1,018.68 / $1,018.68	Facility		$1,018.68	$1,018.68	$1,018.68
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $101.87 / $101.87 / $101.87	Facility	AS	$101.87	$101.87	$101.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $647.91 / $1,214.17 / $3,002.39	Professional		$647.91	$1,214.17	$3,002.39
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 $1,085.94 / $1,566.67 / $2,842.00	Professional		$1,085.94	$1,566.67	$2,842.00
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $932.54 / $932.54 / $932.54	Facility		$932.54	$932.54	$932.54
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $741.39 / $1,209.19 / $2,133.05	Professional		$741.39	$1,209.19	$2,133.05
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,783.57 / $7,455.56 / $13,498.48	Facility		$2,783.57	$7,455.56	$13,498.48
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $654.21 / $831.15 / $1,833.84	Professional		$654.21	$831.15	$1,833.84
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $1,018.68	Facility		$555.00	$597.00	$1,018.68
MVP Health Care Facility/Professional Facility Modifier AS Low / Median / High Price $101.87 / $101.87 / $101.87	Facility	AS	$101.87	$101.87	$101.87
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $702.19 / $1,268.76 / $2,927.07	Professional		$702.19	$1,268.76	$2,927.07
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 $883.17 / $1,271.44 / $3,001.06	Professional		$883.17	$1,271.44	$3,001.06
Univera Facility/Professional Facility Modifier Low / Median / High Price $721.13 / $721.13 / $3,180.18	Facility		$721.13	$721.13	$3,180.18
Univera Facility/Professional Professional Modifier Low / Median / High Price $741.39 / $1,299.58 / $2,133.05	Professional		$741.39	$1,299.58	$2,133.05