Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $94.00 / $121.97 / $390.75	Facility		$94.00	$121.97	$390.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.81 / $91.48 / $137.76	Professional		$65.81	$91.48	$137.76
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $120.00 / $133.75 / $133.75	Professional	25	$120.00	$133.75	$133.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.59 / $88.45 / $139.86	Professional		$75.59	$88.45	$139.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $17.00 / $17.00 / $306.00	Facility		$17.00	$17.00	$306.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $61.97 / $107.29	Professional		$0.80	$61.97	$107.29
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $88.13 / $88.13 / $113.48	Facility		$88.13	$88.13	$113.48
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $88.13 / $113.48 / $126.85	Professional		$88.13	$113.48	$126.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.00 / $125.00 / $140.25	Facility		$42.00	$125.00	$140.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.00 / $95.81 / $243.47	Professional		$49.00	$95.81	$243.47
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $63.00 / $63.00 / $319.00	Facility		$63.00	$63.00	$319.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $93.39 / $118.44 / $179.52	Professional		$93.39	$118.44	$179.52
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.75 / $53.93 / $77.37	Facility		$36.75	$53.93	$77.37
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.52 / $93.98 / $164.16	Professional		$62.52	$93.98	$164.16
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $51.45 / $90.66	Professional		$46.00	$51.45	$90.66
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.58 / $94.14 / $103.31	Professional		$79.58	$94.14	$103.31
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $42.00 / $125.00 / $140.25	Facility		$42.00	$125.00	$140.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $46.00 / $99.72 / $223.02	Professional		$46.00	$99.72	$223.02
Optum Facility/Professional Professional Modifier Low / Median / High Price $57.25 / $92.52 / $121.50	Professional		$57.25	$92.52	$121.50
United Facility/Professional Professional Modifier Low / Median / High Price $67.52 / $96.92 / $207.75	Professional		$67.52	$96.92	$207.75
Univera Facility/Professional Facility Modifier Low / Median / High Price $51.48 / $53.93 / $99.45	Facility		$51.48	$53.93	$99.45
Univera Facility/Professional Professional Modifier Low / Median / High Price $83.48 / $95.27 / $210.23	Professional		$83.48	$95.27	$210.23