Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.65 / $2,792.00 / $9,267.00	Facility		$344.65	$2,792.00	$9,267.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $215.52 / $281.57 / $404.97	Facility	54	$215.52	$281.57	$404.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.07 / $316.88 / $649.97	Professional		$253.07	$316.88	$649.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,689.00 / $3,373.00 / $4,707.00	Facility		$1,689.00	$3,373.00	$4,707.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $276.99 / $351.22 / $722.07	Professional		$276.99	$351.22	$722.07
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $416.59 / $1,254.00 / $4,050.00	Facility		$416.59	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $416.59 / $416.59 / $435.69	Professional		$416.59	$416.59	$435.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $506.07 / $506.07 / $506.07	Facility		$506.07	$506.07	$506.07
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $354.25 / $354.25 / $354.25	Facility	54	$354.25	$354.25	$354.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $299.95 / $438.99 / $1,242.08	Professional		$299.95	$438.99	$1,242.08
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $269.10 / $417.00 / $807.68	Facility		$269.10	$417.00	$807.68
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $343.50 / $490.06 / $724.29	Professional		$343.50	$490.06	$724.29
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $294.98 / $294.98 / $294.98	Facility		$294.98	$294.98	$294.98
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $233.03 / $233.03 / $233.03	Facility	54	$233.03	$233.03	$233.03
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $233.71 / $412.97 / $664.48	Professional		$233.71	$412.97	$664.48
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $395.92 / $395.92 / $400.28	Professional		$395.92	$395.92	$400.28
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $506.07 / $555.00 / $37,776.00	Facility		$506.07	$555.00	$37,776.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $354.25 / $354.25 / $354.25	Facility	54	$354.25	$354.25	$354.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $305.36 / $451.16 / $1,211.51	Professional		$305.36	$451.16	$1,211.51
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 $267.77 / $373.71 / $973.40	Professional		$267.77	$373.71	$973.40
Univera Facility/Professional Facility Modifier Low / Median / High Price $506.46 / $506.46 / $952.89	Facility		$506.46	$506.46	$952.89
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $233.03 / $400.10 / $400.10	Facility	54	$233.03	$400.10	$400.10
Univera Facility/Professional Professional Modifier Low / Median / High Price $256.14 / $442.52 / $760.36	Professional		$256.14	$442.52	$760.36