Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.21 / $156.19 / $398.00	Facility		$113.21	$156.19	$398.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.75 / $112.99 / $158.19	Professional		$84.75	$112.99	$158.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.01 / $110.77 / $120.41	Professional		$100.01	$110.77	$120.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $19.00 / $19.00 / $306.00	Facility		$19.00	$19.00	$306.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $84.73 / $144.62	Professional		$0.80	$84.73	$144.62
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $141.44 / $141.44 / $150.71	Facility		$141.44	$141.44	$150.71
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $141.44 / $142.29 / $167.90	Professional		$141.44	$142.29	$167.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $142.00 / $187.15	Facility		$64.00	$142.00	$187.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $130.00 / $329.22	Professional		$81.00	$130.00	$329.22
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $92.00 / $92.00 / $373.52	Facility		$92.00	$92.00	$373.52
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $124.67 / $157.57 / $239.64	Professional		$124.67	$157.57	$239.64
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.75 / $102.69 / $107.35	Facility		$36.75	$102.69	$107.35
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.32 / $124.47 / $217.57	Professional		$90.32	$124.47	$217.57
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $81.90 / $157.57	Professional		$78.00	$81.90	$157.57
Fidelis Facility/Professional Professional Modifier 22 Low / Median / High Price $78.75 / $78.75 / $78.75	Professional	22	$78.75	$78.75	$78.75
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.33 / $123.91 / $125.27	Professional		$105.33	$123.91	$125.27
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $64.00 / $187.15 / $555.00	Facility		$64.00	$187.15	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $133.10 / $311.70	Professional		$81.00	$133.10	$311.70
Optum Facility/Professional Professional Modifier Low / Median / High Price $76.50 / $122.17 / $158.57	Professional		$76.50	$122.17	$158.57
United Facility/Professional Professional Modifier Low / Median / High Price $96.25 / $127.32 / $264.43	Professional		$96.25	$127.32	$264.43
Univera Facility/Professional Facility Modifier Low / Median / High Price $98.02 / $102.69 / $131.72	Facility		$98.02	$102.69	$131.72
Univera Facility/Professional Professional Modifier Low / Median / High Price $110.63 / $126.27 / $278.43	Professional		$110.63	$126.27	$278.43