Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,884.03 / $7,413.10	Facility		$100.00	$2,884.03	$7,413.10
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $208.93 / $3,388.44 / $6,606.93	Facility	50	$208.93	$3,388.44	$6,606.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $213.80 / $758.58	Professional		$66.07	$213.80	$758.58
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $154.88 / $288.40 / $794.33	Professional	50	$154.88	$288.40	$794.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $257.04	Professional		$52.48	$67.61	$257.04
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $95.50 / $120.23 / $269.15	Professional	50	$95.50	$120.23	$269.15
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 $223.87 / $269.15 / $512.86	Professional		$223.87	$269.15	$512.86
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $338.84 / $407.38 / $758.58	Professional	50	$338.84	$407.38	$758.58
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $1,258.93 / $6,165.95	Facility		$95.50	$1,258.93	$6,165.95
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $269.15	Professional		$95.50	$95.50	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $114.82 / $50,118.72	Facility		$34.67	$114.82	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $229.09 / $707.95	Professional		$74.13	$229.09	$707.95
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $81.28 / $218.78	Facility		$63.10	$81.28	$218.78
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $446.68 / $776.25	Professional		$309.03	$446.68	$776.25
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $316.23 / $537.03	Professional		$169.82	$316.23	$537.03
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $1,096.48 / $3,801.89	Facility		$141.25	$1,096.48	$3,801.89
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $275.42 / $275.42	Professional		$275.42	$275.42	$275.42
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $50,118.72 / $75,857.76	Facility		$173.78	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $346.74 / $645.65	Professional		$229.09	$346.74	$645.65
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 $64.57 / $173.78 / $457.09	Professional		$64.57	$173.78	$457.09
Univera Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $77.62 / $223.87	Facility		$54.95	$77.62	$223.87
Univera Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $269.15 / $501.19	Professional		$151.36	$269.15	$501.19