Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8.81 / $26.51 / $152.50	Facility		$8.81	$26.51	$152.50
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $20.92 / $202.77 / $491.22	Facility	25	$20.92	$202.77	$491.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.35 / $19.82 / $39.47	Professional		$7.35	$19.82	$39.47
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $17.17 / $27.88 / $78.91	Professional	25	$17.17	$27.88	$78.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $16.44 / $22.86 / $38.52	Professional		$16.44	$22.86	$38.52
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $15.53 / $21.71 / $38.49	Professional	25	$15.53	$21.71	$38.49
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 / $16.80 / $36.97	Professional		$0.80	$16.80	$36.97
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $12.72 / $12.72 / $264.00	Facility		$12.72	$12.72	$264.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $12.72 / $12.72 / $31.82	Professional		$12.72	$12.72	$31.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $11.66 / $11.66 / $185.00	Facility		$11.66	$11.66	$185.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $9.25 / $23.09 / $49.74	Professional		$9.25	$23.09	$49.74
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $13.55 / $25.00 / $332.00	Facility		$13.55	$25.00	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $22.03 / $27.15 / $45.09	Professional		$22.03	$27.15	$45.09
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $21.71 / $34.60 / $51.50	Facility		$21.71	$34.60	$51.50
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.98 / $25.41 / $46.47	Professional		$17.98	$25.41	$46.47
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $22.80 / $27.71	Professional		$14.70	$22.80	$27.71
Fidelis Facility/Professional Professional Modifier 25 Low / Median / High Price $19.97 / $20.00 / $27.95	Professional	25	$19.97	$20.00	$27.95
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.59 / $50.00 / $55.94	Facility		$26.59	$50.00	$55.94
Highmark BCBS Facility/Professional Facility Modifier 25 Low / Median / High Price $82.30 / $82.30 / $82.30	Facility	25	$82.30	$82.30	$82.30
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.51 / $31.51 / $55.38	Professional		$21.51	$31.51	$55.38
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $19.70 / $25.31 / $55.38	Professional	25	$19.70	$25.31	$55.38
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $11.66 / $11.66 / $265.00	Facility		$11.66	$11.66	$265.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $10.52 / $27.57 / $51.57	Professional		$10.52	$27.57	$51.57
Optum Facility/Professional Professional Modifier Low / Median / High Price $22.21 / $25.72 / $36.75	Professional		$22.21	$25.72	$36.75
United Facility/Professional Facility Modifier Low / Median / High Price $49.00 / $49.00 / $120.00	Facility		$49.00	$49.00	$120.00
United Facility/Professional Professional Modifier Low / Median / High Price $18.04 / $25.72 / $52.06	Professional		$18.04	$25.72	$52.06
Univera Facility/Professional Facility Modifier Low / Median / High Price $9.01 / $25.84 / $51.50	Facility		$9.01	$25.84	$51.50
Univera Facility/Professional Professional Modifier Low / Median / High Price $19.53 / $26.03 / $43.02	Professional		$19.53	$26.03	$43.02