Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.18 / $242.25 / $449.67	Facility		$103.18	$242.25	$449.67
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $838.19 / $838.19 / $838.19	Facility	25	$838.19	$838.19	$838.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.10 / $167.75 / $345.10	Professional		$113.10	$167.75	$345.10
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $115.53 / $187.89 / $345.10	Professional	25	$115.53	$187.89	$345.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $148.91 / $156.18 / $178.23	Professional		$148.91	$156.18	$178.23
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $156.18 / $241.58 / $298.70	Professional	25	$156.18	$241.58	$298.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.00 / $117.92 / $307.38	Professional		$93.00	$117.92	$307.38
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $235.89 / $235.89 / $235.89	Facility		$235.89	$235.89	$235.89
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $235.89 / $235.89 / $235.89	Professional		$235.89	$235.89	$235.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $187.13 / $187.13	Facility		$187.13	$187.13	$187.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $147.60	Professional		$147.60	$147.60	$147.60
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $152.00 / $256.44 / $617.12	Facility		$152.00	$256.44	$617.12
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $181.11 / $225.52 / $337.26	Professional		$181.11	$225.52	$337.26
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $155.41 / $155.41 / $197.39	Facility		$155.41	$155.41	$197.39
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.16 / $197.39 / $336.05	Professional		$136.16	$197.39	$336.05
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.74 / $186.51 / $227.38	Professional		$178.74	$186.51	$227.38
Highmark BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $132.11 / $178.91 / $180.88	Professional	25	$132.11	$178.91	$180.88
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $187.13 / $187.13	Facility		$187.13	$187.13	$187.13
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $171.46 / $378.53	Professional		$147.60	$171.46	$378.53
United Facility/Professional Professional Modifier Low / Median / High Price $140.41 / $189.87 / $373.41	Professional		$140.41	$189.87	$373.41
Univera Facility/Professional Facility Modifier Low / Median / High Price $155.41 / $179.74 / $197.39	Facility		$155.41	$179.74	$197.39
Univera Facility/Professional Professional Modifier Low / Median / High Price $147.37 / $197.39 / $392.46	Professional		$147.37	$197.39	$392.46