Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $236.40 / $2,807.62 / $8,907.44	Facility		$236.40	$2,807.62	$8,907.44
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $60.69 / $101.20 / $182.08	Facility	52	$60.69	$101.20	$182.08
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $40.47 / $110.91 / $250.46	Facility	53	$40.47	$110.91	$250.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.58 / $274.67 / $666.11	Professional		$144.58	$274.67	$666.11
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $38.46 / $81.20 / $194.49	Professional	53	$38.46	$81.20	$194.49
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.68 / $180.28 / $343.98	Professional		$169.68	$180.28	$343.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,651.00 / $3,189.00 / $4,636.00	Facility		$1,651.00	$3,189.00	$4,636.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $268.70 / $340.39 / $811.84	Professional		$268.70	$340.39	$811.84
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $80.44 / $192.31 / $427.81	Professional	53	$80.44	$192.31	$427.81
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $130.07 / $261.00 / $6,213.00	Facility		$130.07	$261.00	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $130.07 / $245.61 / $491.61	Professional		$130.07	$245.61	$491.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.26 / $243.26 / $4,612.43	Facility		$243.26	$243.26	$4,612.43
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $194.61 / $194.61 / $194.61	Facility	52	$194.61	$194.61	$194.61
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.65 / $48.65 / $48.65	Facility	53	$48.65	$48.65	$48.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.45 / $301.45 / $475.77	Professional		$301.45	$301.45	$475.77
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $132.78 / $196.79 / $361.11	Professional	53	$132.78	$196.79	$361.11
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $204.70 / $281.45 / $489.95	Facility		$204.70	$281.45	$489.95
Emblem Health Facility/Professional Facility Modifier 53 Low / Median / High Price $104.07 / $234.16 / $332.00	Facility	53	$104.07	$234.16	$332.00
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $382.25 / $474.41 / $960.48	Professional		$382.25	$474.41	$960.48
Emblem Health Facility/Professional Professional Modifier 53 Low / Median / High Price $188.85 / $232.66 / $339.69	Professional	53	$188.85	$232.66	$339.69
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $313.32 / $313.32 / $639.45	Facility		$313.32	$313.32	$639.45
Excellus BCBS Facility/Professional Facility Modifier 53 Low / Median / High Price $156.54 / $156.54 / $156.54	Facility	53	$156.54	$156.54	$156.54
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $308.18 / $804.79 / $1,007.58	Professional		$308.18	$804.79	$1,007.58
Excellus BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $127.71 / $577.16 / $695.44	Professional	53	$127.71	$577.16	$695.44
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $930.05 / $1,515.75 / $3,586.45	Facility		$930.05	$1,515.75	$3,586.45
Highmark BCBS Facility/Professional Facility Modifier 52 Low / Median / High Price $393.62 / $1,771.08 / $1,898.77	Facility	52	$393.62	$1,771.08	$1,898.77
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.89 / $188.79 / $441.15	Professional		$184.89	$188.79	$441.15
Highmark BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $93.37 / $93.89 / $94.40	Professional	53	$93.37	$93.89	$94.40
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $243.26 / $597.00 / $5,855.00	Facility		$243.26	$597.00	$5,855.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $194.61 / $194.61 / $194.61	Facility	52	$194.61	$194.61	$194.61
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $48.65 / $48.65 / $48.65	Facility	53	$48.65	$48.65	$48.65
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $301.45 / $385.52 / $837.89	Professional		$301.45	$385.52	$837.89
MVP Health Care Facility/Professional Professional Modifier 53 Low / Median / High Price $178.59 / $246.12 / $476.77	Professional	53	$178.59	$246.12	$476.77
United Facility/Professional Facility Modifier Low / Median / High Price $951.00 / $3,174.00 / $5,807.00	Facility		$951.00	$3,174.00	$5,807.00
United Facility/Professional Professional Modifier Low / Median / High Price $280.35 / $391.17 / $884.68	Professional		$280.35	$391.17	$884.68
United Facility/Professional Professional Modifier 53 Low / Median / High Price $139.66 / $159.61 / $159.61	Professional	53	$139.66	$159.61	$159.61
Univera Facility/Professional Facility Modifier Low / Median / High Price $195.98 / $195.98 / $313.32	Facility		$195.98	$195.98	$313.32
Univera Facility/Professional Facility Modifier 53 Low / Median / High Price $98.17 / $98.17 / $98.17	Facility	53	$98.17	$98.17	$98.17
Univera Facility/Professional Professional Modifier Low / Median / High Price $195.98 / $532.89 / $979.34	Professional		$195.98	$532.89	$979.34
Univera Facility/Professional Professional Modifier 53 Low / Median / High Price $98.17 / $350.72 / $664.36	Professional	53	$98.17	$350.72	$664.36