Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $2,691.53 / $7,413.10	Facility		$173.78	$2,691.53	$7,413.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $162.18 / $371.54	Professional		$120.23	$162.18	$371.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $3,630.78 / $5,011.87	Facility		$1,819.70	$3,630.78	$5,011.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $141.25 / $371.54	Professional		$112.20	$141.25	$371.54
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $6,165.95	Facility		$173.78	$173.78	$6,165.95
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $199.53	Professional		$173.78	$173.78	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $213.80 / $50,118.72	Facility		$34.67	$213.80	$50,118.72
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	54	$151.36	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $204.17 / $524.81	Professional		$128.82	$204.17	$524.81
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $162.18 / $512.86	Facility		$125.89	$162.18	$512.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $251.19 / $363.08	Professional		$181.97	$251.19	$363.08
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Facility		$138.04	$138.04	$138.04
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	54	$109.65	$109.65	$109.65
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $194.98 / $309.03	Professional		$117.49	$194.98	$309.03
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $190.55 / $398.11	Professional		$173.78	$190.55	$398.11
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $50,118.72 / $75,857.76	Facility		$120.23	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $251.19 / $512.86	Professional		$165.96	$251.19	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $2,754.23 / $4,897.79	Facility		$831.76	$2,754.23	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $162.18 / $407.38	Professional		$109.65	$162.18	$407.38
Univera Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $154.88 / $501.19	Facility		$104.71	$154.88	$501.19
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $83.18 / $97.72 / $120.23	Facility	54	$83.18	$97.72	$120.23
Univera Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $181.97 / $398.11	Professional		$117.49	$181.97	$398.11