Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.65 / $183.53 / $460.45	Facility		$137.65	$183.53	$460.45
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $184.46 / $184.46 / $184.46	Facility	25	$184.46	$184.46	$184.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.24 / $164.44 / $251.03	Professional		$124.24	$164.44	$251.03
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $172.37 / $172.37 / $172.37	Professional	25	$172.37	$172.37	$172.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.27 / $184.94 / $211.40	Professional		$131.27	$184.94	$211.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.00 / $114.00 / $241.00	Facility		$114.00	$114.00	$241.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $120.48 / $228.07	Professional		$0.80	$120.48	$228.07
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $192.08 / $192.08 / $249.43	Facility		$192.08	$192.08	$249.43
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $192.08 / $197.62 / $283.80	Professional		$192.08	$197.62	$283.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.00 / $157.00 / $280.49	Facility		$138.00	$157.00	$280.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.88 / $182.39 / $425.07	Professional		$102.88	$182.39	$425.07
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 $189.93 / $240.74 / $365.08	Professional		$189.93	$240.74	$365.08
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.36 / $144.96 / $169.37	Facility		$72.36	$144.96	$169.37
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.30 / $201.54 / $347.13	Professional		$122.30	$201.54	$347.13
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $135.51 / $233.73	Professional		$84.00	$135.51	$233.73
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $65.00 / $444.00	Facility		$65.00	$65.00	$444.00
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $196.23 / $210.59 / $230.00	Professional		$196.23	$210.59	$230.00
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $138.00 / $170.00 / $280.49	Facility		$138.00	$170.00	$280.49
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $104.68 / $185.81 / $407.36	Professional		$104.68	$185.81	$407.36
Optum Facility/Professional Professional Modifier Low / Median / High Price $99.25 / $172.13 / $232.81	Professional		$99.25	$172.13	$232.81
United Facility/Professional Professional Modifier Low / Median / High Price $119.63 / $174.71 / $371.90	Professional		$119.63	$174.71	$371.90
Univera Facility/Professional Facility Modifier Low / Median / High Price $138.37 / $144.96 / $207.89	Facility		$138.37	$144.96	$207.89
Univera Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $237.11 / $439.44	Professional		$177.83	$237.11	$439.44