Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.88 / $88.85 / $148.38	Facility		$60.88	$88.85	$148.38
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $481.28 / $481.28 / $481.28	Facility	25	$481.28	$481.28	$481.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $75.62 / $157.75	Professional		$50.00	$75.62	$157.75
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $13.73 / $83.50 / $193.44	Professional	25	$13.73	$83.50	$193.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.09 / $72.72 / $112.86	Professional		$71.09	$72.72	$112.86
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $71.09 / $77.83 / $135.18	Professional	25	$71.09	$77.83	$135.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.11 / $72.04 / $152.61	Professional		$55.11	$72.04	$152.61
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $109.79 / $109.79 / $109.79	Facility		$109.79	$109.79	$109.79
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $109.79 / $109.79 / $119.81	Professional		$109.79	$109.79	$119.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.27 / $100.27 / $100.27	Facility		$100.27	$100.27	$100.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.29 / $114.92 / $215.99	Professional		$63.29	$114.92	$215.99
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $37.25 / $116.37 / $332.00	Facility		$37.25	$116.37	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $90.01 / $111.31 / $167.72	Professional		$90.01	$111.31	$167.72
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.67 / $77.29 / $91.97	Facility		$73.67	$77.29	$91.97
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.41 / $90.43 / $166.85	Professional		$71.41	$90.43	$166.85
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $85.02 / $89.29 / $94.13	Professional		$85.02	$89.29	$94.13
Fidelis Facility/Professional Professional Modifier 25 Low / Median / High Price $84.35 / $84.35 / $84.35	Professional	25	$84.35	$84.35	$84.35
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.23 / $142.09 / $151.35	Professional		$102.23	$142.09	$151.35
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $79.79 / $111.81 / $155.88	Professional	25	$79.79	$111.81	$155.88
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $100.27 / $100.27 / $100.27	Facility		$100.27	$100.27	$100.27
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $71.86 / $121.25 / $322.62	Professional		$71.86	$121.25	$322.62
United Facility/Professional Professional Modifier Low / Median / High Price $63.80 / $97.16 / $194.08	Professional		$63.80	$97.16	$194.08
United Facility/Professional Professional Modifier 25 Low / Median / High Price $83.64 / $98.97 / $99.10	Professional	25	$83.64	$98.97	$99.10
Univera Facility/Professional Facility Modifier Low / Median / High Price $72.59 / $77.29 / $134.63	Facility		$72.59	$77.29	$134.63
Univera Facility/Professional Professional Modifier Low / Median / High Price $79.54 / $95.44 / $191.79	Professional		$79.54	$95.44	$191.79