Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $3,235.94 / $12,022.64	Facility		$218.78	$3,235.94	$12,022.64
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $707.95 / $3,311.31 / $8,912.51	Facility	50	$707.95	$3,311.31	$8,912.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $218.78 / $676.08	Professional		$104.71	$218.78	$676.08
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $165.96 / $467.74 / $1,230.27	Professional	50	$165.96	$467.74	$1,230.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $107.15 / $177.83	Professional		$100.00	$107.15	$177.83
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $151.36 / $186.21 / $295.12	Professional	50	$151.36	$186.21	$295.12
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 $151.36 / $190.55 / $512.86	Professional		$151.36	$190.55	$512.86
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $229.09 / $281.84 / $758.58	Professional	50	$229.09	$281.84	$758.58
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $1,258.93 / $4,073.80	Facility		$151.36	$1,258.93	$4,073.80
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $275.42	Professional		$151.36	$151.36	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $177.83 / $50,118.72	Facility		$34.67	$177.83	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $239.88 / $812.83	Professional		$120.23	$239.88	$812.83
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $114.82 / $302.00	Facility		$72.44	$114.82	$302.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $338.84 / $676.08	Professional		$234.42	$338.84	$676.08
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $245.47 / $407.38	Professional		$151.36	$245.47	$407.38
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $467.74 / $2,570.40	Facility		$407.38	$467.74	$2,570.40
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $204.17 / $436.52 / $707.95	Facility	50	$204.17	$436.52	$707.95
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $281.84 / $281.84	Professional		$275.42	$281.84	$281.84
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $416.87 / $416.87 / $416.87	Professional	50	$416.87	$416.87	$416.87
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $50,118.72 / $75,857.76	Facility		$93.33	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $331.13 / $537.03	Professional		$234.42	$331.13	$537.03
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 $100.00 / $199.53 / $489.78	Professional		$100.00	$199.53	$489.78
Univera Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $123.03 / $309.03	Facility		$85.11	$123.03	$309.03
Univera Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $229.09 / $389.05	Professional		$158.49	$229.09	$389.05