Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $179.43 / $3,094.00 / $7,839.00	Facility		$179.43	$3,094.00	$7,839.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.11 / $1,490.62 / $2,631.80	Professional		$123.11	$1,490.62	$2,631.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,469.93 / $1,469.93 / $1,469.93	Professional		$1,469.93	$1,469.93	$1,469.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,393.00 / $4,123.00 / $9,074.00	Facility		$2,393.00	$4,123.00	$9,074.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,111.83 / $1,500.35 / $3,463.22	Professional		$1,111.83	$1,500.35	$3,463.22
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,667.76 / $2,250.53 / $5,194.83	Professional	50	$1,667.76	$2,250.53	$5,194.83
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $166.40 / $166.40 / $13,477.50	Facility		$166.40	$166.40	$13,477.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $166.40 / $166.40 / $2,115.35	Professional		$166.40	$166.40	$2,115.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $203.03 / $203.03 / $13,296.25	Facility		$203.03	$203.03	$13,296.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.03 / $423.82 / $3,402.56	Professional		$100.03	$423.82	$3,402.56
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $124.67 / $196.38 / $332.00	Facility		$124.67	$196.38	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,246.46 / $1,628.83 / $2,458.14	Professional		$1,246.46	$1,628.83	$2,458.14
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,123.33 / $1,547.91 / $1,984.36	Professional		$1,123.33	$1,547.91	$1,984.36
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $993.41 / $1,013.99 / $1,089.99	Professional		$993.41	$1,013.99	$1,089.99
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,603.41 / $1,603.41 / $1,809.06	Professional		$1,603.41	$1,603.41	$1,809.06
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $203.03 / $597.00 / $74,999.25	Facility		$203.03	$597.00	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $139.72 / $1,435.02 / $3,604.84	Professional		$139.72	$1,435.02	$3,604.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,768.00 / $3,961.00 / $8,312.00	Facility		$1,768.00	$3,961.00	$8,312.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,327.58 / $1,917.62 / $4,809.39	Professional		$1,327.58	$1,917.62	$4,809.39
Univera Facility/Professional Facility Modifier Low / Median / High Price $147.52 / $147.52 / $188.76	Facility		$147.52	$147.52	$188.76
Univera Facility/Professional Professional Modifier Low / Median / High Price $205.30 / $1,443.18 / $2,343.58	Professional		$205.30	$1,443.18	$2,343.58