Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.00 / $847.44 / $6,197.38	Facility		$169.00	$847.44	$6,197.38
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $884.58 / $2,457.90 / $6,945.00	Facility	25	$884.58	$2,457.90	$6,945.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $169.20 / $561.53 / $689.36	Professional	25	$169.20	$561.53	$689.36
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $173.81 / $445.42 / $630.02	Professional	25	$173.81	$445.42	$630.02
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $251.95 / $251.95 / $1,486.00	Facility		$251.95	$251.95	$1,486.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $202.43 / $202.43 / $2,428.00	Facility		$202.43	$202.43	$2,428.00
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $35.00 / $35.00 / $409.58	Facility		$35.00	$35.00	$409.58
Fidelis Facility/Professional Professional Modifier 25 Low / Median / High Price $172.01 / $172.01 / $172.01	Professional	25	$172.01	$172.01	$172.01
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $215.48 / $292.63 / $528.00	Professional	25	$215.48	$292.63	$528.00
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $202.43 / $202.43 / $2,428.00	Facility		$202.43	$202.43	$2,428.00