Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $262.20 / $4,009.17 / $10,453.21	Facility		$262.20	$4,009.17	$10,453.21
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $30.31 / $88.85 / $183.48	Facility	53	$30.31	$88.85	$183.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $148.83 / $468.99 / $1,258.35	Professional		$148.83	$468.99	$1,258.35
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,393.00 / $4,120.00 / $8,836.00	Facility		$2,393.00	$4,120.00	$8,836.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $430.67 / $556.60 / $1,563.53	Professional		$430.67	$556.60	$1,563.53
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $233.33 / $1,716.00 / $8,917.50	Facility		$233.33	$1,716.00	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $233.33 / $233.33 / $809.61	Professional		$233.33	$233.33	$809.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $276.39 / $276.39 / $5,246.94	Facility		$276.39	$276.39	$5,246.94
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $55.28 / $55.28 / $55.28	Facility	53	$55.28	$55.28	$55.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $192.97 / $569.36 / $2,057.40	Professional		$192.97	$569.36	$2,057.40
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $180.31 / $255.15 / $420.39	Facility		$180.31	$255.15	$420.39
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $502.54 / $681.22 / $1,379.20	Professional		$502.54	$681.22	$1,379.20
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $414.34 / $585.07 / $911.56	Professional		$414.34	$585.07	$911.56
Fidelis Facility/Professional Professional Modifier Low / Median / High Price $171.29 / $496.64 / $496.64	Professional		$171.29	$496.64	$496.64
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,307.43 / $3,858.88 / $5,721.27	Facility		$1,307.43	$3,858.88	$5,721.27
Highmark BCBS Facility/Professional Facility Modifier 53 Low / Median / High Price $4,786.92 / $4,786.92 / $4,786.92	Facility	53	$4,786.92	$4,786.92	$4,786.92
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.07 / $151.07 / $202.90	Professional		$151.07	$151.07	$202.90
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $276.39 / $555.00 / $5,246.94	Facility		$276.39	$555.00	$5,246.94
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $55.28 / $55.28 / $55.28	Facility	53	$55.28	$55.28	$55.28
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $231.89 / $718.92 / $2,013.53	Professional		$231.89	$718.92	$2,013.53
United Facility/Professional Facility Modifier Low / Median / High Price $1,768.00 / $4,176.00 / $8,312.00	Facility		$1,768.00	$4,176.00	$8,312.00
United Facility/Professional Professional Modifier Low / Median / High Price $354.63 / $686.32 / $1,582.02	Professional		$354.63	$686.32	$1,582.02
Univera Facility/Professional Facility Modifier Low / Median / High Price $173.26 / $173.26 / $309.54	Facility		$173.26	$173.26	$309.54
Univera Facility/Professional Professional Modifier Low / Median / High Price $401.46 / $620.63 / $990.84	Professional		$401.46	$620.63	$990.84