Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.19 / $165.76 / $445.00	Facility		$114.19	$165.76	$445.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.90 / $148.63 / $255.69	Professional		$112.90	$148.63	$255.69
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $130.00 / $130.00 / $130.00	Professional	52	$130.00	$130.00	$130.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.63 / $122.84 / $169.32	Professional		$97.63	$122.84	$169.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $114.00 / $241.00	Facility		$85.00	$114.00	$241.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $113.14 / $203.18	Professional		$0.80	$113.14	$203.18
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $171.46 / $171.46 / $221.12	Facility		$171.46	$171.46	$221.12
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $171.46 / $176.54 / $254.54	Professional		$171.46	$176.54	$254.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $157.00 / $246.37	Facility		$110.00	$157.00	$246.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.68 / $152.53 / $310.43	Professional		$104.68	$152.53	$310.43
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $144.00 / $584.64	Facility		$144.00	$144.00	$584.64
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $79.00 / $195.44 / $321.47	Professional		$79.00	$195.44	$321.47
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.36 / $140.28 / $149.09	Facility		$72.36	$140.28	$149.09
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.04 / $177.67 / $311.79	Professional		$124.04	$177.67	$311.79
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $126.00 / $180.25	Professional		$120.00	$126.00	$180.25
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $150.59 / $506.88	Facility		$65.00	$150.59	$506.88
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.46 / $180.23 / $190.00	Professional		$161.46	$180.23	$190.00
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $157.00 / $246.37	Facility		$110.00	$157.00	$246.37
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $104.54 / $155.00 / $319.93	Professional		$104.54	$155.00	$319.93
Optum Facility/Professional Professional Modifier Low / Median / High Price $106.93 / $153.69 / $208.76	Professional		$106.93	$153.69	$208.76
United Facility/Professional Professional Modifier Low / Median / High Price $113.19 / $160.05 / $327.45	Professional		$113.19	$160.05	$327.45
Univera Facility/Professional Facility Modifier Low / Median / High Price $133.91 / $140.28 / $182.17	Facility		$133.91	$140.28	$182.17
Univera Facility/Professional Professional Modifier Low / Median / High Price $158.55 / $211.40 / $385.09	Professional		$158.55	$211.40	$385.09