Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.96 / $141.94 / $350.52	Facility		$56.96	$141.94	$350.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.11 / $68.90 / $243.85	Professional		$49.11	$68.90	$243.85
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $119.16 / $119.16 / $119.16	Professional	25	$119.16	$119.16	$119.16
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $57.12 / $57.12 / $57.12	Professional	CQ	$57.12	$57.12	$57.12
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 $64.11 / $75.00 / $159.01	Professional		$64.11	$75.00	$159.01
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $90.08 / $90.08 / $133.00	Facility		$90.08	$90.08	$133.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $90.08 / $90.08 / $90.08	Professional		$90.08	$90.08	$90.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $125.00 / $350.00	Facility		$80.00	$125.00	$350.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.89 / $86.23 / $138.88	Professional		$60.89	$86.23	$138.88
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $145.35 / $332.00	Facility		$35.00	$145.35	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $55.00 / $123.00	Professional		$45.00	$55.00	$123.00
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.27 / $118.05 / $119.09	Facility		$95.27	$118.05	$119.09
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.00 / $95.27 / $176.63	Professional		$71.00	$95.27	$176.63
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $27.04 / $28.59 / $28.59	Professional		$27.04	$28.59	$28.59
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $211.23 / $211.23 / $213.42	Facility		$211.23	$211.23	$213.42
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.22 / $86.22 / $86.22	Professional		$86.22	$86.22	$86.22
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $113.06 / $555.00 / $597.00	Facility		$113.06	$555.00	$597.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $64.14 / $97.88 / $205.38	Professional		$64.14	$97.88	$205.38
United Facility/Professional Professional Modifier Low / Median / High Price $68.58 / $87.09 / $179.55	Professional		$68.58	$87.09	$179.55
Univera Facility/Professional Facility Modifier Low / Median / High Price $95.27 / $111.00 / $119.47	Facility		$95.27	$111.00	$119.47
Univera Facility/Professional Professional Modifier Low / Median / High Price $82.80 / $111.00 / $214.79	Professional		$82.80	$111.00	$214.79