Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.33 / $2,976.00 / $7,185.00	Facility		$170.33	$2,976.00	$7,185.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $61.35 / $92.58 / $144.25	Facility	52	$61.35	$92.58	$144.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $191.87 / $442.94	Professional		$128.82	$191.87	$442.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $54.98 / $54.98 / $54.98	Professional		$54.98	$54.98	$54.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,691.00 / $3,333.00 / $4,636.00	Facility		$1,691.00	$3,333.00	$4,636.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.66 / $172.12 / $427.72	Professional		$131.66	$172.12	$427.72
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $160.59 / $1,254.00 / $4,050.00	Facility		$160.59	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $160.59 / $160.59 / $245.58	Professional		$160.59	$160.59	$245.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $195.65 / $195.65 / $3,479.91	Facility		$195.65	$195.65	$3,479.91
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $156.52 / $156.52 / $156.52	Facility	52	$156.52	$156.52	$156.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.49 / $256.88 / $616.65	Professional		$121.49	$256.88	$616.65
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $132.79 / $194.60 / $332.00	Facility		$132.79	$194.60	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $196.45 / $229.75 / $343.84	Professional		$196.45	$229.75	$343.84
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.43 / $158.59 / $320.01	Professional		$148.43	$158.59	$320.01
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $195.65 / $597.00 / $8,498.00	Facility		$195.65	$597.00	$8,498.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $156.52 / $156.52 / $156.52	Facility	52	$156.52	$156.52	$156.52
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $137.12 / $257.41 / $600.00	Professional		$137.12	$257.41	$600.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,079.00 / $2,826.00 / $4,851.00	Facility		$1,079.00	$2,826.00	$4,851.00
United Facility/Professional Professional Modifier Low / Median / High Price $145.75 / $218.83 / $509.74	Professional		$145.75	$218.83	$509.74
Univera Facility/Professional Facility Modifier Low / Median / High Price $125.12 / $125.12 / $445.22	Facility		$125.12	$125.12	$445.22
Univera Facility/Professional Professional Modifier Low / Median / High Price $125.12 / $214.43 / $363.73	Professional		$125.12	$214.43	$363.73