Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.95 / $143.47 / $254.46	Professional		$74.95	$143.47	$254.46
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $164.54 / $341.58	Professional	25	$80.00	$164.54	$341.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.83 / $136.83 / $169.07	Professional		$120.83	$136.83	$169.07
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $135.63 / $136.94 / $142.88	Professional	25	$135.63	$136.94	$142.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.30 / $137.65 / $334.94	Professional		$105.30	$137.65	$334.94
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $135.84 / $135.84 / $135.84	Facility		$135.84	$135.84	$135.84
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $135.84 / $135.84 / $212.23	Professional		$135.84	$135.84	$212.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $149.77 / $149.77 / $149.77	Facility		$149.77	$149.77	$149.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.44 / $136.41 / $357.90	Professional		$68.44	$136.41	$357.90
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $72.00 / $72.00 / $72.00	Facility		$72.00	$72.00	$72.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $59.50 / $80.00 / $243.44	Professional		$59.50	$80.00	$243.44
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.73 / $138.40 / $264.77	Professional		$114.73	$138.40	$264.77
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $100.56 / $129.19 / $197.45	Professional		$100.56	$129.19	$197.45
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.89 / $151.94 / $220.49	Professional		$127.89	$151.94	$220.49
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $138.40 / $150.09 / $153.62	Professional	25	$138.40	$150.09	$153.62
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $149.77 / $149.77 / $149.77	Facility		$149.77	$149.77	$149.77
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $86.95 / $167.21 / $369.92	Professional		$86.95	$167.21	$369.92
United Facility/Professional Professional Modifier Low / Median / High Price $80.34 / $132.50 / $271.01	Professional		$80.34	$132.50	$271.01
Univera Facility/Professional Professional Modifier Low / Median / High Price $114.73 / $165.19 / $275.02	Professional		$114.73	$165.19	$275.02