Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $139.25 / $3,020.00 / $10,389.64	Facility		$139.25	$3,020.00	$10,389.64
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $51.75 / $100.95 / $175.92	Facility	52	$51.75	$100.95	$175.92
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $20.70 / $40.38 / $70.37	Facility	53	$20.70	$40.38	$70.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.07 / $193.47 / $407.82	Professional		$94.07	$193.47	$407.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.21 / $60.21 / $60.21	Professional		$60.21	$60.21	$60.21
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 $191.32 / $245.22 / $557.07	Professional		$191.32	$245.22	$557.07
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $119.26 / $1,254.00 / $4,050.00	Facility		$119.26	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $119.26 / $119.26 / $315.01	Professional		$119.26	$119.26	$315.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $143.24 / $143.24 / $3,479.91	Facility		$143.24	$143.24	$3,479.91
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $114.59 / $114.59 / $114.59	Facility	52	$114.59	$114.59	$114.59
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $28.65 / $28.65 / $28.65	Facility	53	$28.65	$28.65	$28.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.04 / $216.56 / $515.15	Professional		$97.04	$216.56	$515.15
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $94.07 / $153.00 / $332.00	Facility		$94.07	$153.00	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $198.36 / $267.76 / $417.25	Professional		$198.36	$267.76	$417.25
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.15 / $213.69 / $366.11	Professional		$181.15	$213.69	$366.11
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,445.63 / $4,384.63 / $12,002.94	Facility		$1,445.63	$4,384.63	$12,002.94
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.22 / $170.22 / $170.22	Professional		$170.22	$170.22	$170.22
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $143.24 / $597.00 / $74,999.25	Facility		$143.24	$597.00	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $114.59 / $114.59 / $114.59	Facility	52	$114.59	$114.59	$114.59
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $28.65 / $28.65 / $28.65	Facility	53	$28.65	$28.65	$28.65
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $105.08 / $273.35 / $559.36	Professional		$105.08	$273.35	$559.36
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.00 / $3,496.00 / $5,963.00	Facility		$1,348.00	$3,496.00	$5,963.00
United Facility/Professional Professional Modifier Low / Median / High Price $208.39 / $285.81 / $613.49	Professional		$208.39	$285.81	$613.49
Univera Facility/Professional Facility Modifier Low / Median / High Price $106.36 / $106.36 / $476.09	Facility		$106.36	$106.36	$476.09
Univera Facility/Professional Professional Modifier Low / Median / High Price $171.62 / $241.21 / $423.57	Professional		$171.62	$241.21	$423.57