Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $252.59 / $2,739.00 / $7,839.00	Facility		$252.59	$2,739.00	$7,839.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $156.13 / $209.12 / $311.17	Facility	54	$156.13	$209.12	$311.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $197.36 / $239.68 / $584.07	Professional		$197.36	$239.68	$584.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $456.81 / $456.81 / $456.81	Professional		$456.81	$456.81	$456.81
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 $184.11 / $240.67 / $551.21	Professional		$184.11	$240.67	$551.21
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $321.93 / $1,254.00 / $4,050.00	Facility		$321.93	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $315.73 / $315.73 / $321.93	Professional		$315.73	$315.73	$321.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $265.22 / $265.22 / $265.22	Facility		$265.22	$265.22	$265.22
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $183.20 / $183.20 / $183.20	Facility	54	$183.20	$183.20	$183.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $221.97 / $323.11 / $832.90	Professional		$221.97	$323.11	$832.90
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $210.00 / $314.20 / $640.15	Facility		$210.00	$314.20	$640.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $255.28 / $363.34 / $589.19	Professional		$255.28	$363.34	$589.19
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $219.22 / $219.22 / $219.22	Facility		$219.22	$219.22	$219.22
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $173.18 / $173.18 / $173.18	Facility	54	$173.18	$173.18	$173.18
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.98 / $277.92 / $490.25	Professional		$174.98	$277.92	$490.25
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.08 / $304.81 / $589.46	Professional		$259.08	$304.81	$589.46
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $265.22 / $555.00 / $597.00	Facility		$265.22	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $183.20 / $183.20 / $183.20	Facility	54	$183.20	$183.20	$183.20
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $221.80 / $325.13 / $816.87	Professional		$221.80	$325.13	$816.87
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 $198.34 / $280.56 / $688.61	Professional		$198.34	$280.56	$688.61
Univera Facility/Professional Facility Modifier Low / Median / High Price $284.24 / $284.24 / $857.92	Facility		$284.24	$284.24	$857.92
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $173.18 / $224.55 / $224.55	Facility	54	$173.18	$224.55	$224.55
Univera Facility/Professional Professional Modifier Low / Median / High Price $188.98 / $305.50 / $589.50	Professional		$188.98	$305.50	$589.50