Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $58.88 / $302.00	Facility		$38.02	$58.88	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.90 / $107.15	Professional		$28.84	$38.90	$107.15
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $97.72 / $181.97 / $229.09	Professional	22	$97.72	$181.97	$229.09
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.70 / $41.69 / $85.11	Professional	52	$25.70	$41.69	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.11 / $39.81	Professional		$28.84	$33.11	$39.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $41.69 / $95.50	Professional		$32.36	$41.69	$95.50
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $46.77	Facility		$46.77	$46.77	$46.77
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $46.77 / $54.95	Professional		$46.77	$46.77	$54.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $51.29 / $257.04	Facility		$43.65	$51.29	$257.04
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $40.74 / $40.74 / $40.74	Facility	52	$40.74	$40.74	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $44.67 / $117.49	Professional		$29.51	$44.67	$117.49
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $46.77 / $102.33	Professional		$28.18	$46.77	$102.33
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Facility		$34.67	$34.67	$34.67
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $34.67 / $64.57	Professional		$25.70	$34.67	$64.57
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $22.39 / $22.39	Professional		$22.39	$22.39	$22.39
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $51.29	Facility		$46.77	$46.77	$51.29
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $43.65 / $60.26	Professional		$38.90	$43.65	$60.26
Highmark BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $19.50 / $21.88 / $38.90	Professional	52	$19.50	$21.88	$38.90
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $46.77 / $67.61	Professional		$34.67	$46.77	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $35.48 / $66.07	Professional		$24.55	$35.48	$66.07
Univera Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $34.67 / $34.67	Facility		$34.67	$34.67	$34.67
Univera Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $33.88 / $63.10	Professional		$28.84	$33.88	$63.10