Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $496.78 / $4,631.59 / $10,024.00	Facility		$496.78	$4,631.59	$10,024.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,604.75 / $5,480.25 / $9,540.00	Facility	50	$2,604.75	$5,480.25	$9,540.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.25 / $942.53 / $3,112.83	Professional		$312.25	$942.53	$3,112.83
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $156.31 / $410.74 / $1,767.68	Professional	50	$156.31	$410.74	$1,767.68
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.41 / $147.41 / $394.02	Professional		$147.41	$147.41	$394.02
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $221.14 / $591.03 / $1,118.02	Professional	50	$221.14	$591.03	$1,118.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,079.00 / $7,264.00 / $12,538.00	Facility		$4,079.00	$7,264.00	$12,538.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,547.56 / $2,069.03 / $4,687.10	Professional		$1,547.56	$2,069.03	$4,687.10
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $2,424.91 / $3,103.55 / $7,051.38	Professional	50	$2,424.91	$3,103.55	$7,051.38
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $496.48 / $496.48 / $12,319.50	Facility		$496.48	$496.48	$12,319.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $496.48 / $496.48 / $2,896.15	Professional		$496.48	$496.48	$2,896.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $621.90 / $621.90 / $7,227.90	Facility		$621.90	$621.90	$7,227.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $373.43 / $1,328.60 / $5,004.93	Professional		$373.43	$1,328.60	$5,004.93
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $493.00 / $994.12	Facility		$332.00	$493.00	$994.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $2,069.23 / $2,804.98 / $4,203.66	Professional		$2,069.23	$2,804.98	$4,203.66
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,260.84 / $2,667.34 / $4,152.64	Professional		$1,260.84	$2,667.34	$4,152.64
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,359.30 / $7,109.54 / $11,292.02	Facility		$5,359.30	$7,109.54	$11,292.02
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,850.12 / $2,850.12 / $2,850.12	Facility	50	$2,850.12	$2,850.12	$2,850.12
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $621.90 / $621.90	Facility		$555.00	$621.90	$621.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $397.38 / $2,113.23 / $5,160.88	Professional		$397.38	$2,113.23	$5,160.88
United Facility/Professional Facility Modifier Low / Median / High Price $2,444.00 / $7,772.00 / $17,108.00	Facility		$2,444.00	$7,772.00	$17,108.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,892.36 / $2,445.87 / $6,250.26	Professional		$1,892.36	$2,445.87	$6,250.26
Univera Facility/Professional Facility Modifier Low / Median / High Price $452.33 / $452.33 / $746.78	Facility		$452.33	$452.33	$746.78
Univera Facility/Professional Professional Modifier Low / Median / High Price $903.77 / $2,504.73 / $4,152.64	Professional		$903.77	$2,504.73	$4,152.64