Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $146.88 / $2,796.66 / $8,442.00	Facility		$146.88	$2,796.66	$8,442.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $56.40 / $138.83 / $235.42	Facility	52	$56.40	$138.83	$235.42
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $22.56 / $55.53 / $94.17	Facility	53	$22.56	$55.53	$94.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.59 / $224.46 / $492.48	Professional		$98.59	$224.46	$492.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.12 / $100.28 / $519.42	Professional		$64.12	$100.28	$519.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,651.00 / $3,263.00 / $4,636.00	Facility		$1,651.00	$3,263.00	$4,636.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.85 / $309.80 / $675.89	Professional		$223.85	$309.80	$675.89
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $149.83 / $1,254.00 / $6,213.00	Facility		$149.83	$1,254.00	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $149.83 / $149.83 / $435.82	Professional		$149.83	$149.83	$435.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $179.49 / $179.49 / $3,479.91	Facility		$179.49	$179.49	$3,479.91
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $143.59 / $143.59 / $143.59	Facility	52	$143.59	$143.59	$143.59
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $35.90 / $35.90 / $35.90	Facility	53	$35.90	$35.90	$35.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.75 / $300.94 / $722.75	Professional		$115.75	$300.94	$722.75
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $110.40 / $177.46 / $346.00	Facility		$110.40	$177.46	$346.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $295.67 / $387.31 / $574.98	Professional		$295.67	$387.31	$574.98
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $264.97 / $264.97 / $482.13	Facility		$264.97	$264.97	$482.13
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.52 / $346.37 / $537.57	Professional		$205.52	$346.37	$537.57
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $120.50 / $120.50 / $120.50	Professional		$120.50	$120.50	$120.50
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $977.33 / $2,318.04 / $4,682.21	Facility		$977.33	$2,318.04	$4,682.21
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $488.67 / $488.67 / $616.42	Facility	52	$488.67	$488.67	$616.42
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.59 / $131.37 / $252.64	Professional		$98.59	$131.37	$252.64
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $179.49 / $555.00 / $3,479.91	Facility		$179.49	$555.00	$3,479.91
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $143.59 / $143.59 / $143.59	Facility	52	$143.59	$143.59	$143.59
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $35.90 / $35.90 / $35.90	Facility	53	$35.90	$35.90	$35.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $129.38 / $367.79 / $746.50	Professional		$129.38	$367.79	$746.50
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 $238.47 / $331.24 / $756.56	Professional		$238.47	$331.24	$756.56
Univera Facility/Professional Facility Modifier Low / Median / High Price $125.64 / $125.64 / $305.35	Facility		$125.64	$125.64	$305.35
Univera Facility/Professional Professional Modifier Low / Median / High Price $205.52 / $346.37 / $550.01	Professional		$205.52	$346.37	$550.01