Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.91 / $111.59 / $201.00	Facility		$66.91	$111.59	$201.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $6,481.33 / $6,481.33 / $6,481.33	Facility	25	$6,481.33	$6,481.33	$6,481.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.77 / $114.39 / $249.19	Professional		$69.77	$114.39	$249.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.59 / $78.59 / $157.16	Professional		$78.59	$78.59	$157.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.76 / $2.98 / $189.85	Professional		$0.76	$2.98	$189.85
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $140.75 / $140.75 / $140.75	Facility		$140.75	$140.75	$140.75
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $140.75 / $140.75 / $140.75	Professional		$140.75	$140.75	$140.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $91.00 / $94.44 / $94.44	Facility		$91.00	$94.44	$94.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.27 / $142.56 / $252.39	Professional		$74.27	$142.56	$252.39
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $107.81 / $332.00	Facility		$60.00	$107.81	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $41.40 / $85.54 / $156.22	Professional		$41.40	$85.54	$156.22
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.90 / $90.10 / $155.56	Professional		$34.90	$90.10	$155.56
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $101.51 / $101.51 / $101.51	Professional		$101.51	$101.51	$101.51
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.23 / $132.90 / $164.96	Professional		$77.23	$132.90	$164.96
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $91.00 / $94.44 / $74,999.25	Facility		$91.00	$94.44	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $79.40 / $138.53 / $252.39	Professional		$79.40	$138.53	$252.39
Optum Facility/Professional Professional Modifier Low / Median / High Price $50.50 / $75.38 / $216.94	Professional		$50.50	$75.38	$216.94
United Facility/Professional Professional Modifier Low / Median / High Price $74.89 / $110.40 / $230.24	Professional		$74.89	$110.40	$230.24
Univera Facility/Professional Facility Modifier Low / Median / High Price $79.18 / $79.18 / $279.14	Facility		$79.18	$79.18	$279.14
Univera Facility/Professional Professional Modifier Low / Median / High Price $67.30 / $95.01 / $209.21	Professional		$67.30	$95.01	$209.21