Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.62 / $16.61 / $80.58	Facility		$10.62	$16.61	$80.58
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $72.90 / $72.90 / $100.22	Facility	25	$72.90	$72.90	$100.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.15 / $13.96 / $32.40	Professional		$10.15	$13.96	$32.40
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $13.59 / $25.35 / $55.00	Professional	25	$13.59	$25.35	$55.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $11.45 / $13.90 / $22.91	Professional		$11.45	$13.90	$22.91
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $13.56 / $14.19 / $24.31	Professional	25	$13.56	$14.19	$24.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $0.80 / $17.64 / $66.15	Professional		$0.80	$17.64	$66.15
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $17.53 / $17.53 / $17.53	Facility		$17.53	$17.53	$17.53
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $17.53 / $17.53 / $21.82	Professional		$17.53	$17.53	$21.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $15.71 / $15.71 / $15.71	Facility		$15.71	$15.71	$15.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.21 / $18.78 / $35.22	Professional		$11.21	$18.78	$35.22
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $12.89 / $18.14 / $332.00	Facility		$12.89	$18.14	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $14.49 / $19.52 / $29.21	Professional		$14.49	$19.52	$29.21
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $11.54 / $13.46 / $21.03	Facility		$11.54	$13.46	$21.03
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.04 / $16.68 / $26.98	Professional		$12.04	$16.68	$26.98
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $9.69 / $14.30 / $17.71	Professional		$9.69	$14.30	$17.71
Fidelis Facility/Professional Professional Modifier 25 Low / Median / High Price $11.36 / $12.72 / $15.46	Professional	25	$11.36	$12.72	$15.46
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.26 / $64.31 / $64.31	Facility		$22.26	$64.31	$64.31
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $16.11 / $18.85 / $27.15	Professional		$16.11	$18.85	$27.15
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $16.57 / $18.82 / $35.58	Professional	25	$16.57	$18.82	$35.58
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $15.71 / $15.71 / $17.89	Facility		$15.71	$15.71	$17.89
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $11.24 / $19.94 / $36.78	Professional		$11.24	$19.94	$36.78
Optum Facility/Professional Professional Modifier Low / Median / High Price $20.60 / $20.60 / $20.60	Professional		$20.60	$20.60	$20.60
United Facility/Professional Professional Modifier Low / Median / High Price $12.22 / $16.48 / $33.42	Professional		$12.22	$16.48	$33.42
Univera Facility/Professional Facility Modifier Low / Median / High Price $6.09 / $13.46 / $25.98	Facility		$6.09	$13.46	$25.98
Univera Facility/Professional Professional Modifier Low / Median / High Price $13.54 / $18.11 / $29.91	Professional		$13.54	$18.11	$29.91