Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.93 / $2,378.96 / $6,962.00	Facility		$82.93	$2,378.96	$6,962.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $143.13 / $2,739.30 / $9,908.64	Facility	50	$143.13	$2,739.30	$9,908.64
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $12.00 / $19.79 / $39.72	Facility	53	$12.00	$19.79	$39.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.59 / $103.90 / $307.97	Professional		$48.59	$103.90	$307.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.93 / $143.31 / $204.41	Professional	50	$69.93	$143.31	$204.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.07 / $104.07 / $139.10	Professional		$104.07	$104.07	$139.10
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 $67.78 / $89.04 / $257.85	Professional		$67.78	$89.04	$257.85
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $105.63 / $133.56 / $387.57	Professional	50	$105.63	$133.56	$387.57
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $73.81 / $1,254.00 / $4,050.00	Facility		$73.81	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $73.81 / $73.81 / $158.32	Professional		$73.81	$73.81	$158.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.31 / $86.31 / $14,648.00	Facility		$86.31	$86.31	$14,648.00
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $17.26 / $17.26 / $17.26	Facility	53	$17.26	$17.26	$17.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $127.41 / $381.04	Professional		$57.54	$127.41	$381.04
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $52.00 / $78.28 / $332.00	Facility		$52.00	$78.28	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $118.51 / $170.97 / $546.58	Professional		$118.51	$170.97	$546.58
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $101.77 / $101.77 / $101.77	Facility		$101.77	$101.77	$101.77
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.27 / $132.03 / $234.80	Professional		$90.27	$132.03	$234.80
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $626.50 / $1,181.33 / $2,403.82	Facility		$626.50	$1,181.33	$2,403.82
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $2,478.40 / $2,478.40 / $2,478.40	Facility	50	$2,478.40	$2,478.40	$2,478.40
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.03 / $105.42 / $151.78	Professional		$76.03	$105.42	$151.78
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $158.13 / $227.67 / $230.18	Professional	50	$158.13	$227.67	$230.18
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $86.31 / $555.00 / $597.00	Facility		$86.31	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $17.26 / $17.26 / $17.26	Facility	53	$17.26	$17.26	$17.26
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $62.90 / $144.04 / $385.65	Professional		$62.90	$144.04	$385.65
United Facility/Professional Facility Modifier Low / Median / High Price $964.00 / $2,826.00 / $4,851.00	Facility		$964.00	$2,826.00	$4,851.00
United Facility/Professional Professional Modifier Low / Median / High Price $92.62 / $146.07 / $332.30	Professional		$92.62	$146.07	$332.30
Univera Facility/Professional Facility Modifier Low / Median / High Price $59.86 / $59.86 / $321.16	Facility		$59.86	$59.86	$321.16
Univera Facility/Professional Professional Modifier Low / Median / High Price $101.77 / $135.34 / $234.80	Professional		$101.77	$135.34	$234.80