Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $2,626.00 / $7,028.00	Facility		$79.43	$2,626.00	$7,028.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $29.73 / $64.88 / $165.24	Facility	52	$29.73	$64.88	$165.24
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $11.89 / $25.95 / $51.45	Facility	53	$11.89	$25.95	$51.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.02 / $137.25 / $313.69	Professional		$58.02	$137.25	$313.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $22.93 / $50.31 / $333.21	Professional		$22.93	$50.31	$333.21
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 $107.79 / $160.93 / $402.86	Professional		$107.79	$160.93	$402.86
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $78.12 / $78.12 / $4,050.00	Facility		$78.12	$78.12	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $78.12 / $78.12 / $268.14	Professional		$78.12	$78.12	$268.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.68 / $95.68 / $3,479.91	Facility		$95.68	$95.68	$3,479.91
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $76.54 / $76.54 / $76.54	Facility	52	$76.54	$76.54	$76.54
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.14 / $19.14 / $19.14	Facility	53	$19.14	$19.14	$19.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.50 / $189.47 / $555.59	Professional		$65.50	$189.47	$555.59
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $65.70 / $115.20 / $332.00	Facility		$65.70	$115.20	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $98.50 / $199.66 / $372.05	Professional		$98.50	$199.66	$372.05
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $171.45 / $171.45 / $482.13	Facility		$171.45	$171.45	$482.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.81 / $243.47 / $343.66	Professional		$116.81	$243.47	$343.66
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $171.45 / $223.53 / $223.53	Professional		$171.45	$223.53	$223.53
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $392.23 / $950.39 / $2,935.20	Facility		$392.23	$950.39	$2,935.20
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.28 / $78.54 / $250.21	Professional		$72.28	$78.54	$250.21
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $95.68 / $555.00 / $5,855.00	Facility		$95.68	$555.00	$5,855.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $76.54 / $76.54 / $76.54	Facility	52	$76.54	$76.54	$76.54
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $19.14 / $19.14 / $19.14	Facility	53	$19.14	$19.14	$19.14
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $71.23 / $217.84 / $521.96	Professional		$71.23	$217.84	$521.96
United Facility/Professional Facility Modifier Low / Median / High Price $951.00 / $3,235.00 / $5,828.00	Facility		$951.00	$3,235.00	$5,828.00
United Facility/Professional Professional Modifier Low / Median / High Price $136.10 / $192.02 / $447.66	Professional		$136.10	$192.02	$447.66
Univera Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $82.00 / $482.13	Facility		$82.00	$82.00	$482.13
Univera Facility/Professional Professional Modifier Low / Median / High Price $116.81 / $247.65 / $371.63	Professional		$116.81	$247.65	$371.63