Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $193.59 / $1,776.00 / $7,185.00	Facility		$193.59	$1,776.00	$7,185.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $107.36 / $172.96 / $248.76	Facility	54	$107.36	$172.96	$248.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.28 / $197.62 / $614.17	Professional		$144.28	$197.62	$614.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,691.00 / $3,382.00 / $4,707.00	Facility		$1,691.00	$3,382.00	$4,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $146.57 / $182.02 / $413.63	Professional		$146.57	$182.02	$413.63
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $219.86 / $278.77 / $643.77	Professional	50	$219.86	$278.77	$643.77
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $256.85 / $1,254.00 / $4,050.00	Facility		$256.85	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $256.85 / $256.85 / $298.86	Professional		$256.85	$256.85	$298.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $308.79 / $308.79 / $308.79	Facility		$308.79	$308.79	$308.79
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $216.15 / $216.15 / $216.15	Facility	54	$216.15	$216.15	$216.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.25 / $260.52 / $642.60	Professional		$150.25	$260.52	$642.60
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $134.00 / $235.28 / $477.05	Facility		$134.00	$235.28	$477.05
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $246.17 / $289.70 / $684.35	Professional		$246.17	$289.70	$684.35
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $175.30 / $199.62 / $398.03	Professional		$175.30	$199.62	$398.03
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $173.68 / $215.86 / $215.86	Professional		$173.68	$215.86	$215.86
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $446.82 / $791.19 / $1,342.40	Facility		$446.82	$791.19	$1,342.40
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $215.95 / $279.88 / $510.81	Professional		$215.95	$279.88	$510.81
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $308.79 / $555.00 / $74,999.25	Facility		$308.79	$555.00	$74,999.25
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $216.15 / $216.15 / $216.15	Facility	54	$216.15	$216.15	$216.15
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $150.55 / $273.55 / $642.60	Professional		$150.55	$273.55	$642.60
United Facility/Professional Facility Modifier Low / Median / High Price $964.00 / $2,826.00 / $4,851.00	Facility		$964.00	$2,826.00	$4,851.00
United Facility/Professional Professional Modifier Low / Median / High Price $136.76 / $239.54 / $525.91	Professional		$136.76	$239.54	$525.91
Univera Facility/Professional Facility Modifier Low / Median / High Price $199.02 / $199.02 / $568.89	Facility		$199.02	$199.02	$568.89
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $179.12 / $179.12 / $179.12	Facility	54	$179.12	$179.12	$179.12
Univera Facility/Professional Professional Modifier Low / Median / High Price $177.58 / $231.25 / $507.34	Professional		$177.58	$231.25	$507.34