Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $231.97 / $2,892.00 / $7,563.00	Facility		$231.97	$2,892.00	$7,563.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $89.85 / $146.86 / $302.89	Facility	52	$89.85	$146.86	$302.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.43 / $280.77 / $703.00	Professional		$169.43	$280.77	$703.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.73 / $156.41 / $369.46	Professional		$70.73	$156.41	$369.46
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 $266.31 / $374.87 / $799.92	Professional		$266.31	$374.87	$799.92
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $233.91 / $1,716.00 / $6,213.00	Facility		$233.91	$1,716.00	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $233.91 / $233.91 / $595.82	Professional		$233.91	$233.91	$595.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $278.89 / $278.89 / $4,612.43	Facility		$278.89	$278.89	$4,612.43
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $223.11 / $223.11 / $223.11	Facility	52	$223.11	$223.11	$223.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.72 / $397.29 / $1,039.90	Professional		$174.72	$397.29	$1,039.90
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $183.96 / $275.94 / $610.00	Facility		$183.96	$275.94	$610.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $207.19 / $420.46 / $785.14	Professional		$207.19	$420.46	$785.14
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $375.24 / $375.24 / $639.45	Facility		$375.24	$375.24	$639.45
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $155.53 / $491.78 / $763.24	Professional		$155.53	$491.78	$763.24
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1.99 / $1,386.60 / $4,962.58	Facility		$1.99	$1,386.60	$4,962.58
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.30 / $213.71 / $323.83	Professional		$153.30	$213.71	$323.83
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $278.89 / $1,340.95 / $5,855.00	Facility		$278.89	$1,340.95	$5,855.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $223.11 / $223.11 / $223.11	Facility	52	$223.11	$223.11	$223.11
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $204.33 / $481.14 / $998.78	Professional		$204.33	$481.14	$998.78
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 $263.33 / $431.73 / $1,074.73	Professional		$263.33	$431.73	$1,074.73
Univera Facility/Professional Facility Modifier Low / Median / High Price $196.81 / $196.81 / $735.72	Facility		$196.81	$196.81	$735.72
Univera Facility/Professional Professional Modifier Low / Median / High Price $155.53 / $511.44 / $825.34	Professional		$155.53	$511.44	$825.34