Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.09 / $116.87 / $207.09	Professional		$29.09	$116.87	$207.09
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $27.49 / $123.94 / $241.40	Professional	25	$27.49	$123.94	$241.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.50 / $130.81 / $136.63	Professional		$115.50	$130.81	$136.63
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $114.45 / $120.92 / $123.13	Professional	25	$114.45	$120.92	$123.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.65 / $113.95 / $270.95	Professional		$89.65	$113.95	$270.95
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $109.16 / $109.16 / $109.16	Facility		$109.16	$109.16	$109.16
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $109.16 / $109.16 / $178.39	Professional		$109.16	$109.16	$178.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.68 / $120.68 / $120.68	Facility		$120.68	$120.68	$120.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.64 / $113.79 / $294.36	Professional		$56.64	$113.79	$294.36
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $48.00 / $48.00	Facility		$48.00	$48.00	$48.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $59.50 / $96.58 / $206.39	Professional		$59.50	$96.58	$206.39
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.28 / $116.87 / $223.47	Professional		$97.28	$116.87	$223.47
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $81.09 / $135.69 / $244.81	Professional		$81.09	$135.69	$244.81
Fidelis Facility/Professional Professional Modifier 25 Low / Median / High Price $97.13 / $97.13 / $148.01	Professional	25	$97.13	$97.13	$148.01
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.85 / $127.84 / $207.99	Professional		$123.85	$127.84	$207.99
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $116.87 / $127.84 / $168.25	Professional	25	$116.87	$127.84	$168.25
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $120.68 / $120.68 / $120.68	Facility		$120.68	$120.68	$120.68
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $68.75 / $138.56 / $312.50	Professional		$68.75	$138.56	$312.50
United Facility/Professional Professional Modifier Low / Median / High Price $75.37 / $111.50 / $204.11	Professional		$75.37	$111.50	$204.11
Univera Facility/Professional Professional Modifier Low / Median / High Price $97.28 / $139.41 / $232.13	Professional		$97.28	$139.41	$232.13