Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $359.49 / $3,414.00 / $10,152.00	Facility		$359.49	$3,414.00	$10,152.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $121.24 / $342.32 / $571.14	Facility	52	$121.24	$342.32	$571.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.74 / $646.82 / $1,183.65	Professional		$229.74	$646.82	$1,183.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $180.27 / $203.61 / $1,297.85	Professional		$180.27	$203.61	$1,297.85
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 $523.23 / $668.90 / $1,639.20	Professional		$523.23	$668.90	$1,639.20
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $316.33 / $1,716.00 / $8,917.50	Facility		$316.33	$1,716.00	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $316.33 / $316.33 / $1,086.46	Professional		$316.33	$316.33	$1,086.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $377.53 / $1,765.00 / $39,142.00	Facility		$377.53	$1,765.00	$39,142.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $302.02 / $302.02 / $302.02	Facility	52	$302.02	$302.02	$302.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $249.95 / $660.60 / $1,775.49	Professional		$249.95	$660.60	$1,775.49
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $243.00 / $324.00 / $567.25	Facility		$243.00	$324.00	$567.25
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $733.10 / $950.57 / $1,414.93	Professional		$733.10	$950.57	$1,414.93
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $639.45 / $639.45 / $652.04	Facility		$639.45	$639.45	$652.04
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $587.46 / $749.85 / $1,340.78	Professional		$587.46	$749.85	$1,340.78
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $181.52 / $181.52 / $181.52	Professional		$181.52	$181.52	$181.52
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,999.42 / $5,436.79 / $6,115.58	Facility		$1,999.42	$5,436.79	$6,115.58
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.94 / $292.32 / $318.05	Professional		$259.94	$292.32	$318.05
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $377.53 / $1,825.00 / $39,142.00	Facility		$377.53	$1,825.00	$39,142.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $302.02 / $302.02 / $302.02	Facility	52	$302.02	$302.02	$302.02
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $278.52 / $872.60 / $1,788.70	Professional		$278.52	$872.60	$1,788.70
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 $587.54 / $822.21 / $1,987.78	Professional		$587.54	$822.21	$1,987.78
Univera Facility/Professional Facility Modifier Low / Median / High Price $265.27 / $265.27 / $639.45	Facility		$265.27	$265.27	$639.45
Univera Facility/Professional Professional Modifier Low / Median / High Price $587.46 / $737.32 / $1,371.80	Professional		$587.46	$737.32	$1,371.80