Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $267.50 / $3,133.00 / $7,632.44	Facility		$267.50	$3,133.00	$7,632.44
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $91.05 / $154.84 / $432.55	Facility	52	$91.05	$154.84	$432.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.27 / $330.08 / $964.54	Professional		$174.27	$330.08	$964.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.29 / $165.49 / $1,056.82	Professional		$84.29	$165.49	$1,056.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,373.00 / $4,085.00 / $8,281.00	Facility		$2,373.00	$4,085.00	$8,281.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $269.87 / $548.07 / $1,158.51	Professional		$269.87	$548.07	$1,158.51
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $248.08 / $1,716.00 / $6,213.00	Facility		$248.08	$1,716.00	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $248.08 / $248.08 / $887.86	Professional		$248.08	$248.08	$887.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $297.07 / $297.07 / $4,612.43	Facility		$297.07	$297.07	$4,612.43
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $237.66 / $237.66 / $237.66	Facility	52	$237.66	$237.66	$237.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.19 / $508.14 / $1,517.50	Professional		$193.19	$508.14	$1,517.50
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $187.00 / $282.00 / $610.00	Facility		$187.00	$282.00	$610.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $207.19 / $599.89 / $1,117.38	Professional		$207.19	$599.89	$1,117.38
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $531.00 / $531.00 / $639.45	Facility		$531.00	$531.00	$639.45
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $203.00 / $702.28 / $1,089.94	Professional		$203.00	$702.28	$1,089.94
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $802.41 / $2,461.37 / $5,615.16	Facility		$802.41	$2,461.37	$5,615.16
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.81 / $224.81 / $246.71	Professional		$224.81	$224.81	$246.71
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $297.07 / $1,409.00 / $5,855.00	Facility		$297.07	$1,409.00	$5,855.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $237.66 / $237.66 / $237.66	Facility	52	$237.66	$237.66	$237.66
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $217.59 / $666.54 / $1,484.60	Professional		$217.59	$666.54	$1,484.60
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 $420.88 / $644.65 / $1,478.76	Professional		$420.88	$644.65	$1,478.76
Univera Facility/Professional Facility Modifier Low / Median / High Price $207.50 / $207.50 / $742.42	Facility		$207.50	$207.50	$742.42
Univera Facility/Professional Professional Modifier Low / Median / High Price $203.00 / $702.28 / $1,178.61	Professional		$203.00	$702.28	$1,178.61