Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $3,162.28 / $8,709.64	Facility		$208.93	$3,162.28	$8,709.64
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $316.23 / $4,265.80 / $8,912.51	Facility	50	$316.23	$4,265.80	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $263.03 / $933.25	Professional		$107.15	$263.03	$933.25
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.25 / $141.25 / $190.55	Professional	22	$141.25	$141.25	$190.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $154.88 / $363.08 / $1,348.96	Professional	50	$154.88	$363.08	$1,348.96
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $50.12 / $97.72 / $186.21	Professional	53	$50.12	$97.72	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $131.83 / $257.04	Professional		$97.72	$131.83	$257.04
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $331.13 / $426.58	Professional	50	$158.49	$331.13	$426.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,819.70 / $3,630.78 / $5,011.87	Facility		$1,819.70	$3,630.78	$5,011.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $676.08	Professional		$158.49	$199.53	$676.08
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $239.88 / $295.12 / $1,023.29	Professional	50	$239.88	$295.12	$1,023.29
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $1,258.93 / $4,073.80	Facility		$158.49	$1,258.93	$4,073.80
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $354.81	Professional		$158.49	$158.49	$354.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $50,118.72	Facility		$186.21	$186.21	$50,118.72
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	22	$223.87	$223.87	$223.87
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $38.02 / $38.02 / $38.02	Facility	53	$38.02	$38.02	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $288.40 / $851.14	Professional		$114.82	$288.40	$851.14
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $134.90 / $169.82 / $323.59	Professional	53	$134.90	$169.82	$323.59
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $125.89 / $380.19	Facility		$104.71	$125.89	$380.19
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $436.52 / $1,621.81	Professional		$302.00	$436.52	$1,621.81
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $309.03 / $524.81	Professional		$208.93	$309.03	$524.81
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $891.25 / $1,288.25 / $3,388.44	Facility		$891.25	$1,288.25	$3,388.44
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,348.96 / $1,905.46 / $4,897.79	Facility	50	$1,348.96	$1,905.46	$4,897.79
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $223.87 / $338.84	Professional		$162.18	$223.87	$338.84
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $338.84 / $512.86 / $512.86	Professional	50	$338.84	$512.86	$512.86
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $50,118.72 / $75,857.76	Facility		$109.65	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $398.11 / $645.65	Professional		$288.40	$398.11	$645.65
MVP Health Care Facility/Professional Professional Modifier 53 Low / Median / High Price $134.90 / $194.98 / $331.13	Professional	53	$134.90	$194.98	$331.13
United Facility/Professional Facility Modifier Low / Median / High Price $1,621.81 / $3,311.31 / $6,165.95	Facility		$1,621.81	$3,311.31	$6,165.95
United Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $234.42 / $562.34	Professional		$104.71	$234.42	$562.34
Univera Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $128.82 / $512.86	Facility		$91.20	$128.82	$512.86
Univera Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $288.40 / $524.81	Professional		$199.53	$288.40	$524.81