Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $2,691.53 / $7,413.10	Facility		$154.88	$2,691.53	$7,413.10
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,318.26 / $1,318.26 / $1,318.26	Facility	50	$1,318.26	$1,318.26	$1,318.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $154.88 / $371.54	Professional		$109.65	$154.88	$371.54
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $151.36 / $223.87 / $660.69	Professional	50	$151.36	$223.87	$660.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
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 $114.82 / $144.54 / $323.59	Professional		$114.82	$144.54	$323.59
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $173.78 / $213.80 / $478.63	Professional	50	$173.78	$213.80	$478.63
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $4,073.80	Facility		$162.18	$162.18	$4,073.80
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $186.21	Professional		$162.18	$162.18	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $194.98 / $50,118.72	Facility		$34.67	$194.98	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $169.82 / $426.58	Professional		$97.72	$169.82	$426.58
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $120.23 / $269.15	Facility		$34.67	$120.23	$269.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $186.21 / $288.40	Professional		$154.88	$186.21	$288.40
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $141.25 / $281.84	Professional		$91.20	$141.25	$281.84
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Facility		$398.11	$398.11	$398.11
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $162.18 / $162.18	Professional		$151.36	$162.18	$162.18
Highmark BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $186.21 / $239.88 / $245.47	Professional	50	$186.21	$239.88	$245.47
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $50,118.72 / $75,857.76	Facility		$102.33	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $190.55 / $398.11	Professional		$154.88	$190.55	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $831.76 / $2,630.27 / $4,897.79	Facility		$831.76	$2,630.27	$4,897.79
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $131.83 / $281.84	Professional		$95.50	$131.83	$281.84
Univera Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $158.49 / $316.23	Facility		$95.50	$158.49	$316.23
Univera Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $141.25 / $295.12	Professional		$93.33	$141.25	$295.12