Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.70 / $213.91 / $503.80	Facility		$118.70	$213.91	$503.80
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $327.67 / $327.67 / $519.69	Facility	25	$327.67	$327.67	$519.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.44 / $227.71 / $455.66	Professional		$143.44	$227.71	$455.66
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $231.39 / $463.84 / $772.00	Professional	25	$231.39	$463.84	$772.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.97 / $197.77 / $419.26	Professional		$154.97	$197.77	$419.26
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $276.43 / $276.43 / $276.43	Facility		$276.43	$276.43	$276.43
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $276.43 / $276.43 / $391.50	Professional		$276.43	$276.43	$391.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $252.50 / $252.50 / $252.50	Facility		$252.50	$252.50	$252.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $157.83 / $288.37 / $602.45	Professional		$157.83	$288.37	$602.45
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $231.01 / $467.75	Facility		$95.00	$231.01	$467.75
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $316.19 / $442.41 / $670.32	Professional		$316.19	$442.41	$670.32
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $155.71 / $263.33 / $263.33	Facility		$155.71	$263.33	$263.33
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.86 / $275.45 / $481.66	Professional		$169.86	$275.45	$481.66
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $310.75 / $553.82 / $663.30	Professional		$310.75	$553.82	$663.30
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $563.79 / $651.55 / $663.30	Professional	25	$563.79	$651.55	$663.30
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $252.50 / $252.50 / $74,999.25	Facility		$252.50	$252.50	$74,999.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $184.47 / $333.58 / $624.97	Professional		$184.47	$333.58	$624.97
United Facility/Professional Professional Modifier Low / Median / High Price $190.53 / $276.51 / $562.42	Professional		$190.53	$276.51	$562.42
Univera Facility/Professional Facility Modifier Low / Median / High Price $183.18 / $263.33 / $324.07	Facility		$183.18	$263.33	$324.07
Univera Facility/Professional Professional Modifier Low / Median / High Price $101.61 / $314.60 / $511.11	Professional		$101.61	$314.60	$511.11