Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.28 / $160.88 / $391.38	Facility		$109.28	$160.88	$391.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.85 / $136.12 / $235.50	Professional		$99.85	$136.12	$235.50
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $442.00 / $442.00 / $442.00	Professional	25	$442.00	$442.00	$442.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.98 / $115.08 / $153.88	Professional		$89.98	$115.08	$153.88
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 / $104.94 / $179.60	Professional		$0.80	$104.94	$179.60
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $170.54 / $170.54 / $190.42	Facility		$170.54	$170.54	$190.42
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $170.54 / $171.46 / $214.77	Professional		$170.54	$171.46	$214.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $170.00 / $231.96	Facility		$80.00	$170.00	$231.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.50 / $132.00 / $269.89	Professional		$82.50	$132.00	$269.89
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 / $180.42 / $296.07	Professional		$65.00	$180.42	$296.07
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.36 / $142.19 / $148.66	Facility		$72.36	$142.19	$148.66
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.55 / $153.86 / $275.82	Professional		$109.55	$153.86	$275.82
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $78.75 / $94.50 / $160.72	Professional		$78.75	$94.50	$160.72
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $127.07 / $159.83 / $509.52	Facility		$127.07	$159.83	$509.52
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.75 / $158.05 / $163.89	Professional		$129.75	$158.05	$163.89
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $231.96 / $555.00	Facility		$80.00	$231.96	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $83.40 / $135.91 / $281.99	Professional		$83.40	$135.91	$281.99
Optum Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $140.12 / $189.10	Professional		$95.00	$140.12	$189.10
United Facility/Professional Professional Modifier Low / Median / High Price $105.21 / $147.07 / $318.77	Professional		$105.21	$147.07	$318.77
Univera Facility/Professional Facility Modifier Low / Median / High Price $135.72 / $142.19 / $164.50	Facility		$135.72	$142.19	$164.50
Univera Facility/Professional Professional Modifier Low / Median / High Price $140.26 / $187.01 / $347.73	Professional		$140.26	$187.01	$347.73