Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $2,630.27 / $9,549.93	Facility		$107.15	$2,630.27	$9,549.93
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $208.93 / $2,089.30 / $3,981.07	Facility	50	$208.93	$2,089.30	$3,981.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $109.65 / $389.05	Professional		$57.54	$109.65	$389.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $89.13 / $194.98 / $489.78	Professional	50	$89.13	$194.98	$489.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $56.23 / $91.20	Professional		$46.77	$56.23	$91.20
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $85.11 / $104.71 / $147.91	Professional	50	$85.11	$104.71	$147.91
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 $75.86 / $93.33 / $251.19	Professional		$75.86	$93.33	$251.19
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $114.82 / $141.25 / $380.19	Professional	50	$114.82	$141.25	$380.19
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $1,258.93 / $4,073.80	Facility		$85.11	$1,258.93	$4,073.80
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $138.04	Professional		$85.11	$85.11	$138.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $102.33 / $50,118.72	Facility		$34.67	$102.33	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $125.89 / $398.11	Professional		$67.61	$125.89	$398.11
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $64.57 / $169.82	Facility		$40.74	$64.57	$169.82
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $165.96 / $338.84	Professional		$117.49	$165.96	$338.84
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $91.20 / $91.20	Facility		$91.20	$91.20	$91.20
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $125.89 / $204.17	Professional		$77.62	$125.89	$204.17
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $208.93 / $1,288.25	Facility		$144.54	$208.93	$1,288.25
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $97.72 / $295.12 / $354.81	Facility	50	$97.72	$295.12	$354.81
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $138.04 / $138.04	Professional		$138.04	$138.04	$138.04
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $208.93 / $208.93 / $208.93	Professional	50	$208.93	$208.93	$208.93
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $50,118.72 / $75,857.76	Facility		$53.70	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $165.96 / $398.11	Professional		$117.49	$165.96	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $2,754.23 / $4,897.79	Facility		$1,258.93	$2,754.23	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $102.33 / $251.19	Professional		$56.23	$102.33	$251.19
Univera Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $69.18 / $173.78	Facility		$47.86	$69.18	$173.78
Univera Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $117.49 / $204.17	Professional		$79.43	$117.49	$204.17