Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.57 / $92.03 / $180.89	Facility		$53.57	$92.03	$180.89
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $87.65 / $87.65 / $87.65	Facility	25	$87.65	$87.65	$87.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.16 / $81.62 / $188.38	Professional		$52.16	$81.62	$188.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $72.56 / $86.48 / $151.77	Professional		$72.56	$86.48	$151.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.76 / $58.50 / $138.51	Professional		$0.76	$58.50	$138.51
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $100.47 / $100.47 / $100.47	Facility		$100.47	$100.47	$100.47
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $100.47 / $100.47 / $100.47	Professional		$100.47	$100.47	$100.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.00 / $89.96 / $89.96	Facility		$81.00	$89.96	$89.96
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $8.72 / $8.72 / $8.72	Facility	AS	$8.72	$8.72	$8.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.89 / $101.92 / $223.58	Professional		$55.89	$101.92	$223.58
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $96.40 / $332.00	Facility		$30.00	$96.40	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $78.89 / $149.46	Professional		$40.00	$78.89	$149.46
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.01 / $86.76 / $145.82	Professional		$26.01	$86.76	$145.82
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $87.37 / $89.40 / $111.36	Professional		$87.37	$89.40	$111.36
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.08 / $101.76 / $186.87	Professional		$74.08	$101.76	$186.87
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $81.00 / $89.96 / $74,999.25	Facility		$81.00	$89.96	$74,999.25
MVP Health Care Facility/Professional Facility Modifier AS Low / Median / High Price $8.72 / $8.72 / $8.72	Facility	AS	$8.72	$8.72	$8.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $63.88 / $101.92 / $189.91	Professional		$63.88	$101.92	$189.91
Optum Facility/Professional Professional Modifier Low / Median / High Price $51.50 / $76.87 / $149.94	Professional		$51.50	$76.87	$149.94
United Facility/Professional Professional Modifier Low / Median / High Price $55.80 / $82.89 / $164.45	Professional		$55.80	$82.89	$164.45
Univera Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $75.75 / $209.56	Facility		$35.40	$75.75	$209.56
Univera Facility/Professional Professional Modifier Low / Median / High Price $31.98 / $90.90 / $200.16	Professional		$31.98	$90.90	$200.16