Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $507.72 / $3,567.36 / $9,094.00	Facility		$507.72	$3,567.36	$9,094.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $3,977.38 / $3,977.38 / $3,977.38	Facility	22	$3,977.38	$3,977.38	$3,977.38
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,594.00 / $14,378.29 / $14,539.13	Facility	50	$9,594.00	$14,378.29	$14,539.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $391.54 / $505.60 / $2,005.90	Professional		$391.54	$505.60	$2,005.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $206.57 / $1,452.75 / $5,876.70	Professional	50	$206.57	$1,452.75	$5,876.70
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $273.97 / $456.60 / $709.28	Professional		$273.97	$456.60	$709.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,385.00 / $4,133.00 / $9,074.00	Facility		$2,385.00	$4,133.00	$9,074.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $322.58 / $415.71 / $1,066.97	Professional		$322.58	$415.71	$1,066.97
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $477.02 / $623.55 / $1,590.26	Professional	50	$477.02	$623.55	$1,590.26
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $614.01 / $1,716.00 / $6,213.00	Facility		$614.01	$1,716.00	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $614.01 / $614.01 / $624.51	Professional		$614.01	$614.01	$624.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $742.64 / $742.64 / $742.64	Facility		$742.64	$742.64	$742.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $411.06 / $662.52 / $1,856.34	Professional		$411.06	$662.52	$1,856.34
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $891.97 / $1,800.00	Facility		$332.00	$891.97	$1,800.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $491.90 / $722.52 / $1,684.90	Professional		$491.90	$722.52	$1,684.90
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $422.41 / $422.41 / $422.41	Facility		$422.41	$422.41	$422.41
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $353.94 / $691.85 / $1,068.29	Professional		$353.94	$691.85	$1,068.29
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $469.35 / $469.35 / $469.35	Professional		$469.35	$469.35	$469.35
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,044.38 / $2,027.78 / $4,657.12	Facility		$1,044.38	$2,027.78	$4,657.12
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,992.49 / $1,992.49 / $1,992.49	Facility	50	$1,992.49	$1,992.49	$1,992.49
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $436.12 / $590.11 / $783.28	Professional		$436.12	$590.11	$783.28
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $885.15 / $929.40 / $929.40	Professional	50	$885.15	$929.40	$929.40
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $742.64	Facility		$555.00	$597.00	$742.64
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $440.03 / $683.21 / $1,833.00	Professional		$440.03	$683.21	$1,833.00
United Facility/Professional Facility Modifier Low / Median / High Price $2,031.00 / $4,840.00 / $9,416.00	Facility		$2,031.00	$4,840.00	$9,416.00
United Facility/Professional Professional Modifier Low / Median / High Price $386.80 / $602.39 / $1,556.05	Professional		$386.80	$602.39	$1,556.05
Univera Facility/Professional Facility Modifier Low / Median / High Price $514.13 / $514.13 / $1,809.32	Facility		$514.13	$514.13	$1,809.32
Univera Facility/Professional Professional Modifier Low / Median / High Price $366.15 / $691.85 / $1,203.68	Professional		$366.15	$691.85	$1,203.68