Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.45 / $110.51 / $315.08	Facility		$61.45	$110.51	$315.08
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $152.47 / $280.83 / $463.08	Facility	25	$152.47	$280.83	$463.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.71 / $109.05 / $275.66	Professional		$62.71	$109.05	$275.66
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $48.50 / $124.76 / $330.38	Professional	25	$48.50	$124.76	$330.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.68 / $112.89 / $137.54	Professional		$77.68	$112.89	$137.54
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $100.09 / $112.89 / $170.02	Professional	25	$100.09	$112.89	$170.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.00 / $150.00 / $198.00	Facility		$83.00	$150.00	$198.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $87.60 / $183.51	Professional		$0.80	$87.60	$183.51
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $117.62 / $117.62 / $391.00	Facility		$117.62	$117.62	$391.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $117.62 / $117.62 / $157.72	Professional		$117.62	$117.62	$157.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $109.51 / $109.51 / $231.49	Facility		$109.51	$109.51	$231.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.57 / $133.97 / $269.81	Professional		$83.57	$133.97	$269.81
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $99.74 / $332.00	Facility		$35.00	$99.74	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $67.59 / $99.56 / $213.61	Professional		$67.59	$99.56	$213.61
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $41.14 / $61.24 / $104.96	Facility		$41.14	$61.24	$104.96
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.27 / $117.56 / $206.72	Professional		$87.27	$117.56	$206.72
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $98.30 / $124.41 / $140.25	Professional		$98.30	$124.41	$140.25
Fidelis Facility/Professional Professional Modifier 25 Low / Median / High Price $72.51 / $98.68 / $143.07	Professional	25	$72.51	$98.68	$143.07
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $216.00 / $216.88 / $219.65	Facility		$216.00	$216.88	$219.65
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $484.77 / $484.77 / $484.77	Facility	25	$484.77	$484.77	$484.77
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.02 / $141.97 / $223.83	Professional		$115.02	$141.97	$223.83
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $112.34 / $138.41 / $227.86	Professional	25	$112.34	$138.41	$227.86
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $109.51 / $109.51 / $265.00	Facility		$109.51	$109.51	$265.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $84.95 / $140.84 / $270.75	Professional		$84.95	$140.84	$270.75
Optum Facility/Professional Professional Modifier Low / Median / High Price $49.50 / $120.78 / $156.30	Professional		$49.50	$120.78	$156.30
United Facility/Professional Professional Modifier Low / Median / High Price $71.00 / $115.78 / $235.14	Professional		$71.00	$115.78	$235.14
Univera Facility/Professional Facility Modifier Low / Median / High Price $37.61 / $61.24 / $160.69	Facility		$37.61	$61.24	$160.69
Univera Facility/Professional Professional Modifier Low / Median / High Price $94.75 / $125.21 / $208.98	Professional		$94.75	$125.21	$208.98