Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $136.66 / $2,660.00 / $7,168.00	Facility		$136.66	$2,660.00	$7,168.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $48.85 / $102.44 / $188.23	Facility	52	$48.85	$102.44	$188.23
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.54 / $40.98 / $75.29	Facility	53	$19.54	$40.98	$75.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.81 / $204.88 / $457.96	Professional		$90.81	$204.88	$457.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.26 / $78.26 / $78.26	Professional		$78.26	$78.26	$78.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,651.00 / $3,263.00 / $4,636.00	Facility		$1,651.00	$3,263.00	$4,636.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.36 / $239.57 / $532.27	Professional		$185.36	$239.57	$532.27
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $122.81 / $1,254.00 / $4,050.00	Facility		$122.81	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $122.81 / $122.81 / $375.38	Professional		$122.81	$122.81	$375.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $147.60 / $1,025.00 / $39,142.00	Facility		$147.60	$1,025.00	$39,142.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	52	$118.08	$118.08	$118.08
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.52 / $29.52 / $29.52	Facility	53	$29.52	$29.52	$29.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.79 / $261.17 / $714.67	Professional		$105.79	$261.17	$714.67
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $105.68 / $150.50 / $346.00	Facility		$105.68	$150.50	$346.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $270.89 / $360.15 / $743.47	Professional		$270.89	$360.15	$743.47
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $240.00 / $240.00 / $482.13	Facility		$240.00	$240.00	$482.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.52 / $322.32 / $485.74	Professional		$191.52	$322.32	$485.74
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,782.57 / $4,782.57 / $4,782.57	Facility		$4,782.57	$4,782.57	$4,782.57
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.15 / $122.15 / $122.15	Professional		$122.15	$122.15	$122.15
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $147.60 / $1,218.00 / $39,142.00	Facility		$147.60	$1,218.00	$39,142.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	52	$118.08	$118.08	$118.08
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $29.52 / $29.52 / $29.52	Facility	53	$29.52	$29.52	$29.52
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $119.15 / $311.31 / $710.00	Professional		$119.15	$311.31	$710.00
United Facility/Professional Facility Modifier Low / Median / High Price $1,269.00 / $3,612.00 / $8,133.00	Facility		$1,269.00	$3,612.00	$8,133.00
United Facility/Professional Professional Modifier Low / Median / High Price $206.11 / $294.11 / $637.79	Professional		$206.11	$294.11	$637.79
Univera Facility/Professional Facility Modifier Low / Median / High Price $104.48 / $104.48 / $482.13	Facility		$104.48	$104.48	$482.13
Univera Facility/Professional Professional Modifier Low / Median / High Price $191.52 / $312.98 / $525.26	Professional		$191.52	$312.98	$525.26