Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $283.93 / $2,976.00 / $8,327.49	Facility		$283.93	$2,976.00	$8,327.49
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $95.00 / $156.04 / $285.08	Facility	52	$95.00	$156.04	$285.08
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.00 / $62.42 / $114.04	Facility	53	$38.00	$62.42	$114.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.46 / $283.18 / $663.31	Professional		$183.46	$283.18	$663.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.63 / $166.46 / $328.28	Professional		$82.63	$166.46	$328.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,651.00 / $3,189.00 / $4,636.00	Facility		$1,651.00	$3,189.00	$4,636.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $266.55 / $347.79 / $761.80	Professional		$266.55	$347.79	$761.80
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $249.13 / $1,716.00 / $6,213.00	Facility		$249.13	$1,716.00	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $249.13 / $249.13 / $557.08	Professional		$249.13	$249.13	$557.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $296.61 / $296.61 / $4,612.43	Facility		$296.61	$296.61	$4,612.43
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.04 / $404.30 / $1,119.99	Professional		$194.04	$404.30	$1,119.99
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $195.44 / $282.00 / $610.00	Facility		$195.44	$282.00	$610.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $243.75 / $490.17 / $840.32	Professional		$243.75	$490.17	$840.32
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $350.12 / $350.12 / $639.45	Facility		$350.12	$350.12	$639.45
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $310.55 / $491.76 / $708.79	Professional		$310.55	$491.76	$708.79
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $864.88 / $1,832.16 / $3,826.27	Facility		$864.88	$1,832.16	$3,826.27
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $204.73 / $229.89 / $514.10	Professional		$204.73	$229.89	$514.10
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $296.61 / $1,340.95 / $5,855.00	Facility		$296.61	$1,340.95	$5,855.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $220.15 / $462.60 / $979.65	Professional		$220.15	$462.60	$979.65
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 $286.76 / $413.87 / $946.59	Professional		$286.76	$413.87	$946.59
Univera Facility/Professional Facility Modifier Low / Median / High Price $209.11 / $209.11 / $786.65	Facility		$209.11	$209.11	$786.65
Univera Facility/Professional Professional Modifier Low / Median / High Price $310.55 / $474.95 / $766.47	Professional		$310.55	$474.95	$766.47