Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.84 / $91.02 / $504.23	Facility		$35.84	$91.02	$504.23
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $54.11 / $580.26 / $912.56	Facility	50	$54.11	$580.26	$912.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.34 / $53.02 / $112.40	Professional		$30.34	$53.02	$112.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.36 / $162.93 / $355.50	Professional	50	$77.36	$162.93	$355.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.56 / $54.64 / $59.42	Professional		$23.56	$54.64	$59.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $3,373.00 / $4,707.00	Facility		$1,689.00	$3,373.00	$4,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.16 / $60.59 / $127.23	Professional		$44.16	$60.59	$127.23
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $72.44 / $90.55 / $191.13	Professional	50	$72.44	$90.55	$191.13
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $37.39 / $37.39 / $4,050.00	Facility		$37.39	$37.39	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $37.39 / $37.39 / $89.91	Professional		$37.39	$37.39	$89.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.88 / $44.88 / $14,648.00	Facility		$44.88	$44.88	$14,648.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.13 / $73.81 / $171.26	Professional		$31.13	$73.81	$171.26
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $30.50 / $43.88 / $332.00	Facility		$30.50	$43.88	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $60.00 / $91.15 / $139.62	Professional		$60.00	$91.15	$139.62
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.50 / $58.50 / $58.50	Facility		$58.50	$58.50	$58.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.56 / $64.90 / $134.68	Professional		$43.56	$64.90	$134.68
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $55.47 / $55.47	Professional		$55.47	$55.47	$55.47
Fidelis Facility/Professional Professional Modifier 50 Low / Median / High Price $83.48 / $83.48 / $83.48	Professional	50	$83.48	$83.48	$83.48
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $150.34 / $239.92 / $582.40	Facility		$150.34	$239.92	$582.40
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $230.75 / $230.75 / $434.97	Facility	50	$230.75	$230.75	$434.97
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.59 / $69.59 / $87.45	Professional		$69.59	$69.59	$87.45
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $44.88 / $555.00 / $597.00	Facility		$44.88	$555.00	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $35.02 / $79.31 / $164.03	Professional		$35.02	$79.31	$164.03
United Facility/Professional Facility Modifier Low / Median / High Price $964.00 / $2,826.00 / $4,851.00	Facility		$964.00	$2,826.00	$4,851.00
United Facility/Professional Professional Modifier Low / Median / High Price $54.96 / $78.56 / $198.28	Professional		$54.96	$78.56	$198.28
Univera Facility/Professional Facility Modifier Low / Median / High Price $31.34 / $31.34 / $174.90	Facility		$31.34	$31.34	$174.90
Univera Facility/Professional Professional Modifier Low / Median / High Price $43.56 / $79.40 / $134.68	Professional		$43.56	$79.40	$134.68