Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.98 / $986.67 / $4,032.19	Facility		$65.98	$986.67	$4,032.19
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $517.73 / $1,808.90 / $4,810.56	Facility	25	$517.73	$1,808.90	$4,810.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.47 / $67.65 / $199.00	Professional		$50.47	$67.65	$199.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $68.59 / $189.06 / $304.00	Professional	25	$68.59	$189.06	$304.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.36 / $198.50 / $252.00	Professional		$77.36	$198.50	$252.00
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $69.98 / $172.07 / $254.18	Professional	25	$69.98	$172.07	$254.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.60 / $72.73 / $165.40	Professional		$57.60	$72.73	$165.40
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $101.76 / $101.76 / $1,142.00	Facility		$101.76	$101.76	$1,142.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $101.76 / $101.76 / $101.76	Professional		$101.76	$101.76	$101.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.02 / $82.02 / $2,244.00	Facility		$82.02	$82.02	$2,244.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $110.46 / $226.86	Professional		$57.66	$110.46	$226.86
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $35.00 / $165.04	Facility		$35.00	$35.00	$165.04
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $78.59 / $106.88 / $181.55	Professional		$78.59	$106.88	$181.55
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.76 / $86.17 / $136.76	Professional		$50.76	$86.17	$136.76
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $57.67 / $61.51 / $84.58	Professional		$57.67	$61.51	$84.58
Fidelis Facility/Professional Professional Modifier 25 Low / Median / High Price $69.19 / $69.19 / $69.19	Professional	25	$69.19	$69.19	$69.19
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.84 / $125.63 / $286.69	Professional		$79.84	$125.63	$286.69
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $80.27 / $109.99 / $273.98	Professional	25	$80.27	$109.99	$273.98
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $82.02 / $82.02 / $2,244.00	Facility		$82.02	$82.02	$2,244.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $64.84 / $96.21 / $209.55	Professional		$64.84	$96.21	$209.55
Optum Facility/Professional Professional Modifier Low / Median / High Price $56.84 / $74.87 / $86.95	Professional		$56.84	$74.87	$86.95
United Facility/Professional Professional Modifier Low / Median / High Price $50.13 / $79.55 / $182.68	Professional		$50.13	$79.55	$182.68
Univera Facility/Professional Professional Modifier Low / Median / High Price $50.76 / $104.64 / $173.22	Professional		$50.76	$104.64	$173.22