Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.38 / $202.54 / $310.49	Facility		$134.38	$202.54	$310.49
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $292.64 / $292.64 / $292.64	Facility	25	$292.64	$292.64	$292.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $138.13 / $199.65 / $476.57	Professional		$138.13	$199.65	$476.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $163.10 / $189.56 / $371.30	Professional		$163.10	$189.56	$371.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.76 / $139.44 / $383.56	Professional		$0.76	$139.44	$383.56
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $279.89 / $279.89 / $279.89	Facility		$279.89	$279.89	$279.89
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $279.89 / $279.89 / $279.89	Professional		$279.89	$279.89	$279.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $171.00 / $197.63 / $197.63	Facility		$171.00	$197.63	$197.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.91 / $284.18 / $513.00	Professional		$151.91	$284.18	$513.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $60.00 / $211.26 / $431.62	Facility		$60.00	$211.26	$431.62
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $71.33 / $172.65 / $327.30	Professional		$71.33	$172.65	$327.30
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.62 / $190.14 / $320.39	Professional		$70.62	$190.14	$320.39
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $195.67 / $206.80 / $243.80	Professional		$195.67	$206.80	$243.80
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $183.64 / $282.89 / $444.00	Professional		$183.64	$282.89	$444.00
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $171.00 / $197.63 / $74,999.25	Facility		$171.00	$197.63	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $159.58 / $279.20 / $513.00	Professional		$159.58	$279.20	$513.00
Optum Facility/Professional Professional Modifier Low / Median / High Price $106.00 / $158.22 / $418.12	Professional		$106.00	$158.22	$418.12
United Facility/Professional Professional Modifier Low / Median / High Price $154.13 / $228.95 / $458.36	Professional		$154.13	$228.95	$458.36
Univera Facility/Professional Facility Modifier Low / Median / High Price $166.44 / $166.44 / $570.60	Facility		$166.44	$166.44	$570.60
Univera Facility/Professional Professional Modifier Low / Median / High Price $141.47 / $199.72 / $439.77	Professional		$141.47	$199.72	$439.77