Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $407.28 / $2,626.00 / $8,114.00	Facility		$407.28	$2,626.00	$8,114.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $151.52 / $259.54 / $1,824.24	Facility	52	$151.52	$259.54	$1,824.24
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $58.26 / $89.66 / $153.01	Facility	53	$58.26	$89.66	$153.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $264.51 / $484.56 / $1,088.40	Professional		$264.51	$484.56	$1,088.40
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $52.72 / $93.24 / $145.96	Professional	53	$52.72	$93.24	$145.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $204.88 / $245.01 / $333.39	Professional		$204.88	$245.01	$333.39
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 $357.98 / $450.82 / $1,189.32	Professional		$357.98	$450.82	$1,189.32
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $357.94 / $1,716.00 / $6,213.00	Facility		$357.94	$1,716.00	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $357.94 / $357.94 / $659.21	Professional		$357.94	$357.94	$659.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $426.66 / $426.66 / $4,612.43	Facility		$426.66	$426.66	$4,612.43
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $341.33 / $341.33 / $341.33	Facility	52	$341.33	$341.33	$341.33
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $85.33 / $85.33 / $85.33	Facility	53	$85.33	$85.33	$85.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $309.00 / $576.76 / $1,370.16	Professional		$309.00	$576.76	$1,370.16
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $282.00 / $339.00 / $694.95	Facility		$282.00	$339.00	$694.95
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $243.75 / $560.63 / $904.43	Professional		$243.75	$560.63	$904.43
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $416.79 / $416.79 / $639.45	Facility		$416.79	$416.79	$639.45
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.79 / $827.57 / $1,190.67	Professional		$416.79	$827.57	$1,190.67
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $275.89 / $299.37 / $455.31	Professional		$275.89	$299.37	$455.31
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $713.58 / $1,584.76 / $3,461.00	Facility		$713.58	$1,584.76	$3,461.00
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $393.62 / $393.62 / $393.62	Facility	52	$393.62	$393.62	$393.62
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $379.80 / $444.50 / $786.81	Professional		$379.80	$444.50	$786.81
Highmark BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $189.90 / $191.99 / $219.83	Professional	53	$189.90	$191.99	$219.83
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $426.66 / $597.00 / $5,855.00	Facility		$426.66	$597.00	$5,855.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $341.33 / $341.33 / $341.33	Facility	52	$341.33	$341.33	$341.33
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $85.33 / $85.33 / $85.33	Facility	53	$85.33	$85.33	$85.33
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $337.23 / $593.29 / $1,326.23	Professional		$337.23	$593.29	$1,326.23
MVP Health Care Facility/Professional Professional Modifier 53 Low / Median / High Price $230.62 / $296.20 / $489.84	Professional	53	$230.62	$296.20	$489.84
United Facility/Professional Facility Modifier Low / Median / High Price $1,355.74 / $3,439.00 / $7,167.00	Facility		$1,355.74	$3,439.00	$7,167.00
United Facility/Professional Professional Modifier Low / Median / High Price $383.08 / $547.49 / $1,276.61	Professional		$383.08	$547.49	$1,276.61
Univera Facility/Professional Facility Modifier Low / Median / High Price $365.29 / $365.29 / $1,892.57	Facility		$365.29	$365.29	$1,892.57
Univera Facility/Professional Professional Modifier Low / Median / High Price $459.30 / $825.36 / $1,190.67	Professional		$459.30	$825.36	$1,190.67