Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $153.44 / $268.33	Facility		$115.00	$153.44	$268.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.32 / $129.41 / $176.58	Professional		$101.32	$129.41	$176.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.24 / $99.09 / $120.69	Professional		$89.24	$99.09	$120.69
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $148.00 / $148.00 / $263.00	Facility		$148.00	$148.00	$263.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $136.52 / $199.50	Professional		$0.80	$136.52	$199.50
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $180.95 / $180.95 / $180.95	Facility		$180.95	$180.95	$180.95
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $180.95 / $180.95 / $204.34	Professional		$180.95	$180.95	$204.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $224.16 / $224.16 / $317.00	Facility		$224.16	$224.16	$317.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $161.19 / $301.48	Professional		$105.00	$161.19	$301.48
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 / $173.89 / $286.30	Professional		$65.00	$173.89	$286.30
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.42 / $123.42 / $273.31	Facility		$123.42	$123.42	$273.31
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.27 / $166.27 / $303.04	Professional		$122.27	$166.27	$303.04
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $126.00 / $126.00	Professional		$126.00	$126.00	$126.00
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $239.33 / $239.33 / $239.33	Facility		$239.33	$239.33	$239.33
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $122.11 / $130.40 / $152.47	Professional		$122.11	$130.40	$152.47
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $224.16 / $224.16 / $555.00	Facility		$224.16	$224.16	$555.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $105.00 / $163.41 / $303.54	Professional		$105.00	$163.41	$303.54
Optum Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $141.31 / $188.79	Professional		$95.00	$141.31	$188.79
United Facility/Professional Professional Modifier Low / Median / High Price $105.98 / $146.16 / $291.35	Professional		$105.98	$146.16	$291.35
Univera Facility/Professional Facility Modifier Low / Median / High Price $145.85 / $158.87 / $273.31	Facility		$145.85	$158.87	$273.31
Univera Facility/Professional Professional Modifier Low / Median / High Price $134.85 / $179.80 / $335.83	Professional		$134.85	$179.80	$335.83