Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.28 / $102.91 / $397.97	Facility		$20.28	$102.91	$397.97
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $6.53 / $362.00 / $378.22	Facility	CO	$6.53	$362.00	$378.22
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $44.72 / $143.00 / $396.86	Facility	CQ	$44.72	$143.00	$396.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.20 / $27.28 / $118.00	Professional		$13.20	$27.28	$118.00
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $58.40 / $58.40 / $58.40	Professional	CO	$58.40	$58.40	$58.40
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $23.16 / $48.93 / $97.04	Professional	CQ	$23.16	$48.93	$97.04
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $15.67 / $15.67 / $22.49	Professional	CQ	$15.67	$15.67	$22.49
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $654.00 / $664.00 / $919.00	Facility		$654.00	$664.00	$919.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.56 / $33.22 / $75.00	Professional		$20.56	$33.22	$75.00
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $60.05 / $60.05 / $60.05	Facility		$60.05	$60.05	$60.05
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $60.05 / $60.05 / $60.05	Professional		$60.05	$60.05	$60.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.54 / $125.00 / $350.00	Facility		$36.54	$125.00	$350.00
Cigna Facility/Professional Facility Modifier CO Low / Median / High Price $27.88 / $27.88 / $27.88	Facility	CO	$27.88	$27.88	$27.88
Cigna Facility/Professional Facility Modifier CQ Low / Median / High Price $27.88 / $27.88 / $27.88	Facility	CQ	$27.88	$27.88	$27.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.10 / $66.53 / $113.98	Professional		$25.10	$66.53	$113.98
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $27.00 / $50.38 / $332.00	Facility		$27.00	$50.38	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $36.13 / $45.00 / $85.00	Professional		$36.13	$45.00	$85.00
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $27.99 / $34.69 / $34.99	Facility		$27.99	$34.69	$34.99
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.22 / $29.57 / $62.82	Professional		$24.22	$29.57	$62.82
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $17.63 / $21.33 / $26.25	Professional		$17.63	$21.33	$26.25
Fidelis Facility/Professional Professional Modifier CQ Low / Median / High Price $25.19 / $25.19 / $25.19	Professional	CQ	$25.19	$25.19	$25.19
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $8.97 / $24.57 / $102.48	Facility		$8.97	$24.57	$102.48
Highmark BCBS Facility/Professional Facility Modifier CQ Low / Median / High Price $29.63 / $29.63 / $29.63	Facility	CQ	$29.63	$29.63	$29.63
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $24.42 / $43.44 / $46.48	Professional		$24.42	$43.44	$46.48
Highmark BCBS Facility/Professional Professional Modifier CQ Low / Median / High Price $24.75 / $24.75 / $24.86	Professional	CQ	$24.75	$24.75	$24.86
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $36.54 / $350.00 / $597.00	Facility		$36.54	$350.00	$597.00
MVP Health Care Facility/Professional Facility Modifier CO Low / Median / High Price $27.88 / $27.88 / $27.88	Facility	CO	$27.88	$27.88	$27.88
MVP Health Care Facility/Professional Facility Modifier CQ Low / Median / High Price $27.88 / $27.88 / $27.88	Facility	CQ	$27.88	$27.88	$27.88
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $27.56 / $57.22 / $108.29	Professional		$27.56	$57.22	$108.29
United Facility/Professional Professional Modifier Low / Median / High Price $22.22 / $30.51 / $61.59	Professional		$22.22	$30.51	$61.59
Univera Facility/Professional Facility Modifier Low / Median / High Price $27.99 / $32.46 / $85.97	Facility		$27.99	$32.46	$85.97
Univera Facility/Professional Professional Modifier Low / Median / High Price $24.22 / $32.46 / $75.28	Professional		$24.22	$32.46	$75.28