Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $903.52 / $6,719.88 / $24,941.92	Facility		$903.52	$6,719.88	$24,941.92
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $7,275.00 / $7,275.00 / $7,275.00	Facility	22	$7,275.00	$7,275.00	$7,275.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $324.61 / $399.19 / $585.74	Facility	52	$324.61	$399.19	$585.74
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $129.84 / $159.68 / $234.30	Facility	53	$129.84	$159.68	$234.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $633.96 / $859.34 / $2,560.00	Professional		$633.96	$859.34	$2,560.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,144.17 / $1,144.17 / $1,144.17	Professional		$1,144.17	$1,144.17	$1,144.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,527.00 / $7,688.00 / $23,945.00	Facility		$4,527.00	$7,688.00	$23,945.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $504.00 / $649.49 / $1,780.73	Professional		$504.00	$649.49	$1,780.73
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $930.82 / $3,652.50 / $10,957.50	Facility		$930.82	$3,652.50	$10,957.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $930.82 / $930.82 / $930.82	Professional		$930.82	$930.82	$930.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $753.07 / $24,246.00 / $29,212.00	Facility		$753.07	$24,246.00	$29,212.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $594.13 / $594.13 / $594.13	Facility	52	$594.13	$594.13	$594.13
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $148.53 / $148.53 / $148.53	Facility	53	$148.53	$148.53	$148.53
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $74.27 / $74.27 / $74.27	Facility	AS	$74.27	$74.27	$74.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $561.57 / $1,077.67 / $2,544.04	Professional		$561.57	$1,077.67	$2,544.04
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $784.35 / $8,640.00	Facility		$332.00	$784.35	$8,640.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $713.86 / $924.48 / $1,959.15	Professional		$713.86	$924.48	$1,959.15
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $614.66 / $614.66 / $1,522.50	Facility		$614.66	$614.66	$1,522.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $533.78 / $872.82 / $1,218.27	Professional		$533.78	$872.82	$1,218.27
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $817.81 / $817.81 / $817.81	Professional		$817.81	$817.81	$817.81
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,746.06 / $7,454.70 / $15,536.90	Facility		$2,746.06	$7,454.70	$15,536.90
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $780.47 / $784.74 / $1,311.28	Professional		$780.47	$784.74	$1,311.28
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $753.07 / $11,205.00 / $29,212.00	Facility		$753.07	$11,205.00	$29,212.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $594.13 / $594.13 / $594.13	Facility	52	$594.13	$594.13	$594.13
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $148.53 / $148.53 / $148.53	Facility	53	$148.53	$148.53	$148.53
MVP Health Care Facility/Professional Facility Modifier AS Low / Median / High Price $74.27 / $74.27 / $74.27	Facility	AS	$74.27	$74.27	$74.27
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $674.20 / $1,011.46 / $2,447.34	Professional		$674.20	$1,011.46	$2,447.34
United Facility/Professional Facility Modifier Low / Median / High Price $2,264.00 / $6,344.00 / $16,782.00	Facility		$2,264.00	$6,344.00	$16,782.00
United Facility/Professional Professional Modifier Low / Median / High Price $563.80 / $768.33 / $1,820.30	Professional		$563.80	$768.33	$1,820.30
Univera Facility/Professional Facility Modifier Low / Median / High Price $784.97 / $784.97 / $2,715.43	Facility		$784.97	$784.97	$2,715.43
Univera Facility/Professional Professional Modifier Low / Median / High Price $574.69 / $880.37 / $1,668.78	Professional		$574.69	$880.37	$1,668.78