Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $116.28 / $900.00 / $4,709.70	Facility		$116.28	$900.00	$4,709.70
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $684.40 / $1,180.11 / $5,997.79	Facility	25	$684.40	$1,180.11	$5,997.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.99 / $121.34 / $377.85	Professional		$87.99	$121.34	$377.85
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $98.57 / $247.56 / $575.00	Professional	25	$98.57	$247.56	$575.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.91 / $341.78 / $443.22	Professional		$130.91	$341.78	$443.22
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $118.39 / $373.15 / $434.40	Professional	25	$118.39	$373.15	$434.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.24 / $121.52 / $300.00	Professional		$96.24	$121.52	$300.00
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $172.92 / $172.92 / $1,142.00	Facility		$172.92	$172.92	$1,142.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $172.92 / $172.92 / $172.92	Professional		$172.92	$172.92	$172.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.63 / $139.63 / $2,428.00	Facility		$139.63	$139.63	$2,428.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.34 / $188.42 / $401.33	Professional		$96.34	$188.42	$401.33
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $35.00 / $282.32	Facility		$35.00	$35.00	$282.32
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $134.44 / $172.06 / $330.91	Professional		$134.44	$172.06	$330.91
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.60 / $146.88 / $243.28	Professional		$93.60	$146.88	$243.28
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $88.98 / $105.14 / $144.56	Professional		$88.98	$105.14	$144.56
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.16 / $230.13 / $460.94	Professional		$146.16	$230.13	$460.94
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $145.97 / $203.70 / $471.08	Professional	25	$145.97	$203.70	$471.08
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $139.63 / $139.63 / $2,428.00	Facility		$139.63	$139.63	$2,428.00
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $174.95 / $396.23	Professional		$109.65	$174.95	$396.23
Optum Facility/Professional Professional Modifier Low / Median / High Price $95.54 / $133.44 / $152.74	Professional		$95.54	$133.44	$152.74
United Facility/Professional Professional Modifier Low / Median / High Price $87.85 / $138.60 / $341.81	Professional		$87.85	$138.60	$341.81
Univera Facility/Professional Professional Modifier Low / Median / High Price $93.60 / $178.06 / $294.77	Professional		$93.60	$178.06	$294.77