Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.96 / $102.80 / $363.00	Facility		$19.96	$102.80	$363.00
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $77.78 / $77.78 / $77.78	Facility	CO	$77.78	$77.78	$77.78
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $185.71 / $185.71 / $185.71	Facility	CQ	$185.71	$185.71	$185.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $23.69 / $149.00	Professional		$14.40	$23.69	$149.00
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $20.48 / $70.01 / $70.01	Professional	CO	$20.48	$70.01	$70.01
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 $22.12 / $36.57 / $75.00	Professional		$22.12	$36.57	$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 $39.13 / $80.00 / $226.00	Facility		$39.13	$80.00	$226.00
Cigna Facility/Professional Facility Modifier CO Low / Median / High Price $31.05 / $31.05 / $31.05	Facility	CO	$31.05	$31.05	$31.05
Cigna Facility/Professional Facility Modifier CQ Low / Median / High Price $31.05 / $31.05 / $31.05	Facility	CQ	$31.05	$31.05	$31.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.57 / $68.58 / $114.34	Professional		$29.57	$68.58	$114.34
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $56.70 / $332.00	Facility		$35.00	$56.70	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $38.52 / $45.00 / $85.00	Professional		$38.52	$45.00	$85.00
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.06 / $38.49 / $38.83	Facility		$31.06	$38.49	$38.83
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.90 / $32.13 / $68.00	Professional		$26.90	$32.13	$68.00
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $23.85 / $29.17 / $29.17	Professional		$23.85	$29.17	$29.17
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $40.08 / $85.58 / $120.24	Facility		$40.08	$85.58	$120.24
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.34 / $27.34 / $27.34	Professional		$27.34	$27.34	$27.34
Highmark BCBS Facility/Professional Professional Modifier CQ Low / Median / High Price $27.57 / $27.57 / $27.57	Professional	CQ	$27.57	$27.57	$27.57
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $39.13 / $555.00 / $597.00	Facility		$39.13	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier CO Low / Median / High Price $31.05 / $31.05 / $31.05	Facility	CO	$31.05	$31.05	$31.05
MVP Health Care Facility/Professional Facility Modifier CQ Low / Median / High Price $31.05 / $31.05 / $31.05	Facility	CQ	$31.05	$31.05	$31.05
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $31.06 / $60.15 / $111.17	Professional		$31.06	$60.15	$111.17
United Facility/Professional Professional Modifier Low / Median / High Price $24.62 / $32.65 / $61.55	Professional		$24.62	$32.65	$61.55
Univera Facility/Professional Facility Modifier Low / Median / High Price $31.06 / $36.06 / $92.16	Facility		$31.06	$36.06	$92.16
Univera Facility/Professional Professional Modifier Low / Median / High Price $26.90 / $36.06 / $83.63	Professional		$26.90	$36.06	$83.63