Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.74 / $126.73 / $390.75	Facility		$84.74	$126.73	$390.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.20 / $96.00 / $168.90	Professional		$73.20	$96.00	$168.90
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $80.00 / $80.00	Professional	25	$80.00	$80.00	$80.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.65 / $76.75 / $104.29	Professional		$57.65	$76.75	$104.29
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $85.00 / $198.00	Facility		$60.00	$85.00	$198.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $90.53 / $121.83	Professional		$0.80	$90.53	$121.83
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $113.29 / $113.29 / $128.74	Facility		$113.29	$113.29	$128.74
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $113.29 / $114.21 / $145.44	Professional		$113.29	$114.21	$145.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $119.00 / $156.66	Facility		$75.00	$119.00	$156.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.42 / $96.00 / $182.95	Professional		$67.42	$96.00	$182.95
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $104.00 / $104.00 / $422.24	Facility		$104.00	$104.00	$422.24
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $121.77 / $199.71	Professional		$65.00	$121.77	$199.71
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.36 / $94.85 / $99.16	Facility		$72.36	$94.85	$99.16
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.93 / $105.12 / $185.72	Professional		$66.93	$105.12	$185.72
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $74.26 / $84.00 / $108.65	Professional		$74.26	$84.00	$108.65
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $89.55 / $409.63	Facility		$65.00	$89.55	$409.63
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.88 / $107.34 / $138.10	Professional		$87.88	$107.34	$138.10
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $119.00 / $170.00	Facility		$75.00	$119.00	$170.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $68.00 / $98.00 / $189.82	Professional		$68.00	$98.00	$189.82
Optum Facility/Professional Professional Modifier Low / Median / High Price $74.25 / $98.41 / $135.00	Professional		$74.25	$98.41	$135.00
United Facility/Professional Professional Modifier Low / Median / High Price $76.72 / $101.95 / $206.36	Professional		$76.72	$101.95	$206.36
Univera Facility/Professional Facility Modifier Low / Median / High Price $90.54 / $94.85 / $111.46	Facility		$90.54	$94.85	$111.46
Univera Facility/Professional Professional Modifier Low / Median / High Price $95.14 / $126.86 / $235.60	Professional		$95.14	$126.86	$235.60