Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $899.93 / $5,325.06 / $11,609.00	Facility		$899.93	$5,325.06	$11,609.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $72.38 / $179.99 / $339.82	Facility	53	$72.38	$179.99	$339.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $339.77 / $1,062.00 / $2,315.52	Professional		$339.77	$1,062.00	$2,315.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $348.64 / $348.64 / $348.64	Professional		$348.64	$348.64	$348.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,263.00 / $5,184.00 / $11,809.00	Facility		$3,263.00	$5,184.00	$11,809.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $828.22 / $1,129.48 / $3,166.56	Professional		$828.22	$1,129.48	$3,166.56
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $470.06 / $1,990.00 / $8,917.50	Facility		$470.06	$1,990.00	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $470.06 / $470.06 / $1,526.66	Professional		$470.06	$470.06	$1,526.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $557.98 / $557.98 / $5,246.94	Facility		$557.98	$557.98	$5,246.94
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $111.60 / $111.60 / $111.60	Facility	53	$111.60	$111.60	$111.60
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $55.80 / $55.80 / $55.80	Facility	AS	$55.80	$55.80	$55.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $294.67 / $853.42 / $2,320.34	Professional		$294.67	$853.42	$2,320.34
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $319.00 / $435.00 / $850.10	Facility		$319.00	$435.00	$850.10
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $939.37 / $1,242.77 / $2,689.33	Professional		$939.37	$1,242.77	$2,689.33
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $857.08 / $1,079.44 / $1,651.52	Professional		$857.08	$1,079.44	$1,651.52
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $953.06 / $953.06 / $953.06	Professional		$953.06	$953.06	$953.06
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,341.94 / $4,731.96 / $7,123.00	Facility		$2,341.94	$4,731.96	$7,123.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $402.32 / $402.32 / $786.38	Professional		$402.32	$402.32	$786.38
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $74,999.25	Facility		$555.00	$597.00	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $111.60 / $111.60 / $111.60	Facility	53	$111.60	$111.60	$111.60
MVP Health Care Facility/Professional Facility Modifier AS Low / Median / High Price $55.80 / $55.80 / $55.80	Facility	AS	$55.80	$55.80	$55.80
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $388.56 / $1,246.29 / $2,696.85	Professional		$388.56	$1,246.29	$2,696.85
United Facility/Professional Facility Modifier Low / Median / High Price $2,406.00 / $4,893.00 / $10,046.00	Facility		$2,406.00	$4,893.00	$10,046.00
United Facility/Professional Professional Modifier Low / Median / High Price $947.11 / $1,420.66 / $3,321.96	Professional		$947.11	$1,420.66	$3,321.96
Univera Facility/Professional Facility Modifier Low / Median / High Price $416.01 / $416.01 / $1,308.66	Facility		$416.01	$416.01	$1,308.66
Univera Facility/Professional Professional Modifier Low / Median / High Price $774.17 / $1,088.07 / $1,910.70	Professional		$774.17	$1,088.07	$1,910.70