Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $412.64 / $2,877.79 / $7,301.36	Facility		$412.64	$2,877.79	$7,301.36
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $120.16 / $261.70 / $3,552.01	Facility	52	$120.16	$261.70	$3,552.01
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.06 / $82.53 / $140.81	Facility	53	$48.06	$82.53	$140.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.11 / $437.06 / $1,020.00	Professional		$208.11	$437.06	$1,020.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $104.05 / $208.53 / $365.39	Professional	52	$104.05	$208.53	$365.39
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $41.62 / $82.88 / $137.87	Professional	53	$41.62	$82.88	$137.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.11 / $188.33 / $273.85	Professional		$162.11	$188.33	$273.85
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $20.14 / $42.85 / $71.20	Professional	52	$20.14	$42.85	$71.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,373.00 / $3,699.00 / $7,148.00	Facility		$2,373.00	$3,699.00	$7,148.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.45 / $423.06 / $1,083.41	Professional		$338.45	$423.06	$1,083.41
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $283.06 / $1,504.50 / $6,213.00	Facility		$283.06	$1,504.50	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $283.06 / $283.06 / $635.41	Professional		$283.06	$283.06	$635.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.16 / $338.16 / $4,612.43	Facility		$338.16	$338.16	$4,612.43
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $270.52 / $270.52 / $270.52	Facility	52	$270.52	$270.52	$270.52
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $67.63 / $67.63 / $67.63	Facility	53	$67.63	$67.63	$67.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $247.19 / $524.77 / $1,262.27	Professional		$247.19	$524.77	$1,262.27
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $237.00 / $319.00 / $610.00	Facility		$237.00	$319.00	$610.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $240.00 / $483.25 / $859.56	Professional		$240.00	$483.25	$859.56
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $396.11 / $396.11 / $639.45	Facility		$396.11	$396.11	$639.45
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $396.11 / $741.01 / $1,151.64	Professional		$396.11	$741.01	$1,151.64
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $219.23 / $431.50 / $436.17	Professional		$219.23	$431.50	$436.17
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $867.94 / $1,600.27 / $3,810.42	Facility		$867.94	$1,600.27	$3,810.42
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $299.33 / $568.60 / $754.69	Professional		$299.33	$568.60	$754.69
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $185.69 / $185.69 / $375.02	Professional	52	$185.69	$185.69	$375.02
Highmark BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $149.66 / $175.98 / $375.02	Professional	53	$149.66	$175.98	$375.02
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $338.16 / $597.00 / $5,855.00	Facility		$338.16	$597.00	$5,855.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $270.52 / $270.52 / $270.52	Facility	52	$270.52	$270.52	$270.52
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $67.63 / $67.63 / $67.63	Facility	53	$67.63	$67.63	$67.63
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $285.98 / $567.96 / $1,217.00	Professional		$285.98	$567.96	$1,217.00
MVP Health Care Facility/Professional Professional Modifier 53 Low / Median / High Price $219.87 / $283.98 / $461.78	Professional	53	$219.87	$283.98	$461.78
United Facility/Professional Facility Modifier Low / Median / High Price $1,269.00 / $3,612.00 / $8,028.00	Facility		$1,269.00	$3,612.00	$8,028.00
United Facility/Professional Professional Modifier Low / Median / High Price $361.09 / $523.49 / $1,264.52	Professional		$361.09	$523.49	$1,264.52
Univera Facility/Professional Facility Modifier Low / Median / High Price $288.61 / $288.61 / $1,589.81	Facility		$288.61	$288.61	$1,589.81
Univera Facility/Professional Professional Modifier Low / Median / High Price $409.38 / $677.44 / $1,151.64	Professional		$409.38	$677.44	$1,151.64