Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $203.95 / $3,120.07 / $7,773.00	Facility		$203.95	$3,120.07	$7,773.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $69.44 / $119.14 / $222.32	Facility	52	$69.44	$119.14	$222.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.34 / $273.14 / $552.50	Professional		$130.34	$273.14	$552.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $124.67 / $124.67 / $124.67	Professional		$124.67	$124.67	$124.67
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,393.00 / $4,120.00 / $8,836.00	Facility		$2,393.00	$4,120.00	$8,836.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.59 / $272.10 / $754.26	Professional		$214.59	$272.10	$754.26
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $185.82 / $1,254.00 / $4,050.00	Facility		$185.82	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $185.82 / $185.82 / $351.97	Professional		$185.82	$185.82	$351.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $222.71 / $222.71 / $3,479.91	Facility		$222.71	$222.71	$3,479.91
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $178.17 / $178.17 / $178.17	Facility	52	$178.17	$178.17	$178.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.40 / $312.45 / $822.74	Professional		$137.40	$312.45	$822.74
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $147.00 / $220.50 / $346.00	Facility		$147.00	$220.50	$346.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $258.77 / $337.82 / $526.16	Professional		$258.77	$337.82	$526.16
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $214.46 / $282.68 / $462.40	Professional		$214.46	$282.68	$462.40
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,717.50 / $2,306.80 / $9,184.79	Facility		$1,717.50	$2,306.80	$9,184.79
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $222.71 / $597.00 / $8,498.00	Facility		$222.71	$597.00	$8,498.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $178.17 / $178.17 / $178.17	Facility	52	$178.17	$178.17	$178.17
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $161.78 / $338.90 / $853.20	Professional		$161.78	$338.90	$853.20
United Facility/Professional Facility Modifier Low / Median / High Price $1,768.00 / $4,176.00 / $8,312.00	Facility		$1,768.00	$4,176.00	$8,312.00
United Facility/Professional Professional Modifier Low / Median / High Price $209.32 / $300.33 / $668.75	Professional		$209.32	$300.33	$668.75
Univera Facility/Professional Facility Modifier Low / Median / High Price $141.66 / $141.66 / $522.85	Facility		$141.66	$141.66	$522.85
Univera Facility/Professional Professional Modifier Low / Median / High Price $202.60 / $309.85 / $500.02	Professional		$202.60	$309.85	$500.02