Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,004.61 / $3,991.63 / $10,686.00	Facility		$1,004.61	$3,991.63	$10,686.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $769.62 / $994.68 / $2,391.54	Professional		$769.62	$994.68	$2,391.54
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $56.73 / $220.33 / $727.08	Professional	AS	$56.73	$220.33	$727.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,263.00 / $5,196.00 / $11,909.00	Facility		$3,263.00	$5,196.00	$11,909.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $888.14 / $1,134.02 / $2,265.98	Professional		$888.14	$1,134.02	$2,265.98
Anthem BCBS Facility/Professional Professional Modifier AS Low / Median / High Price $126.69 / $158.76 / $317.23	Professional	AS	$126.69	$158.76	$317.23
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $1,216.65 / $3,183.00 / $13,009.50	Facility		$1,216.65	$3,183.00	$13,009.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $1,216.65 / $1,216.65 / $1,528.90	Professional		$1,216.65	$1,216.65	$1,528.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,467.20 / $1,467.20 / $1,467.20	Facility		$1,467.20	$1,467.20	$1,467.20
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $146.72 / $146.72 / $146.72	Facility	AS	$146.72	$146.72	$146.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $651.01 / $1,300.77 / $3,017.76	Professional		$651.01	$1,300.77	$3,017.76
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $925.41 / $2,274.86	Facility		$332.00	$925.41	$2,274.86
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $1,269.81 / $1,471.83 / $3,110.89	Professional		$1,269.81	$1,471.83	$3,110.89
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $714.25 / $1,008.66 / $1,999.83	Professional		$714.25	$1,008.66	$1,999.83
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,943.50 / $5,099.92 / $10,814.16	Facility		$2,943.50	$5,099.92	$10,814.16
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,184.15 / $1,272.96 / $1,443.88	Professional		$1,184.15	$1,272.96	$1,443.88
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $1,467.20 / $74,999.25	Facility		$555.00	$1,467.20	$74,999.25
MVP Health Care Facility/Professional Facility Modifier AS Low / Median / High Price $146.72 / $146.72 / $146.72	Facility	AS	$146.72	$146.72	$146.72
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $767.45 / $1,402.82 / $3,297.40	Professional		$767.45	$1,402.82	$3,297.40
United Facility/Professional Facility Modifier Low / Median / High Price $2,264.00 / $5,963.00 / $11,176.00	Facility		$2,264.00	$5,963.00	$11,176.00
United Facility/Professional Professional Modifier Low / Median / High Price $737.95 / $1,276.14 / $2,767.83	Professional		$737.95	$1,276.14	$2,767.83
Univera Facility/Professional Facility Modifier Low / Median / High Price $930.23 / $930.23 / $2,131.30	Facility		$930.23	$930.23	$2,131.30
Univera Facility/Professional Professional Modifier Low / Median / High Price $714.25 / $1,161.89 / $2,549.01	Professional		$714.25	$1,161.89	$2,549.01