Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $5,011.87 / $10,000.00	Facility		$213.80	$5,011.87	$10,000.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,137.96 / $5,888.44 / $10,000.00	Facility	50	$2,137.96	$5,888.44	$10,000.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $186.21 / $660.69	Professional		$128.82	$186.21	$660.69
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $151.36 / $389.05 / $933.25	Professional	50	$151.36	$389.05	$933.25
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $323.59 / $323.59 / $346.74	Professional	50	$323.59	$323.59	$346.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,630.27 / $4,786.30 / $10,232.93	Facility		$2,630.27	$4,786.30	$10,232.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $151.36 / $426.58	Professional		$120.23	$151.36	$426.58
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $177.83 / $229.09 / $645.65	Professional	50	$177.83	$229.09	$645.65
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $1,995.26 / $8,912.51	Facility		$223.87	$1,995.26	$8,912.51
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.15 / $2,290.87 / $50,118.72	Facility		$269.15	$2,290.87	$50,118.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $309.03 / $691.83	Professional		$125.89	$309.03	$691.83
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $302.00 / $562.34	Facility		$169.82	$302.00	$562.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $204.17 / $302.00	Professional		$151.36	$204.17	$302.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $186.21 / $338.84	Professional		$131.83	$186.21	$338.84
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,905.46 / $3,162.28 / $6,606.93	Facility		$1,905.46	$3,162.28	$6,606.93
Highmark BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,380.38 / $4,466.84 / $8,317.64	Facility	50	$1,380.38	$4,466.84	$8,317.64
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $50,118.72 / $75,857.76	Facility		$218.78	$50,118.72	$75,857.76
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $234.42 / $398.11	Professional		$190.55	$234.42	$398.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $3,890.45 / $8,317.64	Facility		$1,862.09	$3,890.45	$8,317.64
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $169.82 / $467.74	Professional		$87.10	$169.82	$467.74
Univera Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $169.82 / $562.34	Facility		$131.83	$169.82	$562.34
Univera Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $186.21 / $501.19	Professional		$131.83	$186.21	$501.19