Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.71 / $2,065.42 / $7,563.00	Facility		$177.71	$2,065.42	$7,563.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $22.65 / $54.56 / $92.11	Facility	53	$22.65	$54.56	$92.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.91 / $227.45 / $531.03	Professional		$92.91	$227.45	$531.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $236.37 / $236.37 / $321.83	Professional		$236.37	$236.37	$321.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $3,373.00 / $4,707.00	Facility		$1,689.00	$3,373.00	$4,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.68 / $244.98 / $569.62	Professional		$172.68	$244.98	$569.62
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $140.31 / $1,254.00 / $4,050.00	Facility		$140.31	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $140.31 / $140.31 / $377.12	Professional		$140.31	$140.31	$377.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $168.56 / $168.56 / $168.56	Facility		$168.56	$168.56	$168.56
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $33.71 / $33.71 / $33.71	Facility	53	$33.71	$33.71	$33.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $110.64 / $279.85 / $752.98	Professional		$110.64	$279.85	$752.98
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $88.98 / $153.37 / $366.76	Facility		$88.98	$153.37	$366.76
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $274.81 / $417.70 / $1,488.64	Professional		$274.81	$417.70	$1,488.64
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $235.99 / $235.99 / $235.99	Facility		$235.99	$235.99	$235.99
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.72 / $391.14 / $676.50	Professional		$213.72	$391.14	$676.50
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $473.15 / $473.15 / $473.15	Professional		$473.15	$473.15	$473.15
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $327.36 / $1,190.79 / $2,694.24	Facility		$327.36	$1,190.79	$2,694.24
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $341.84 / $341.84 / $341.84	Professional		$341.84	$341.84	$341.84
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $168.56 / $555.00 / $597.00	Facility		$168.56	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $33.71 / $33.71 / $33.71	Facility	53	$33.71	$33.71	$33.71
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $120.60 / $316.22 / $754.96	Professional		$120.60	$316.22	$754.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.00 / $3,496.00 / $6,201.00	Facility		$1,348.00	$3,496.00	$6,201.00
United Facility/Professional Professional Modifier Low / Median / High Price $226.59 / $341.52 / $772.09	Professional		$226.59	$341.52	$772.09
Univera Facility/Professional Facility Modifier Low / Median / High Price $115.65 / $115.65 / $235.99	Facility		$115.65	$115.65	$235.99
Univera Facility/Professional Professional Modifier Low / Median / High Price $235.45 / $355.50 / $586.08	Professional		$235.45	$355.50	$586.08