Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $276.43 / $2,902.00 / $8,134.00	Facility		$276.43	$2,902.00	$8,134.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $169.59 / $219.33 / $326.60	Facility	54	$169.59	$219.33	$326.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.49 / $248.22 / $498.88	Professional		$207.49	$248.22	$498.88
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 $194.67 / $254.48 / $566.27	Professional		$194.67	$254.48	$566.27
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $343.55 / $1,254.00 / $4,050.00	Facility		$343.55	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $333.53 / $333.53 / $343.55	Professional		$333.53	$333.53	$343.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $278.24 / $278.24 / $278.24	Facility		$278.24	$278.24	$278.24
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $192.34 / $192.34 / $192.34	Facility	54	$192.34	$192.34	$192.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.52 / $349.97 / $887.82	Professional		$237.52	$349.97	$887.82
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $301.39 / $678.15	Facility		$130.00	$301.39	$678.15
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $267.92 / $380.93 / $562.23	Professional		$267.92	$380.93	$562.23
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $230.07 / $230.07 / $230.07	Facility		$230.07	$230.07	$230.07
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $181.75 / $181.75 / $181.75	Facility	54	$181.75	$181.75	$181.75
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $186.54 / $291.79 / $514.72	Professional		$186.54	$291.79	$514.72
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $274.49 / $333.22 / $641.52	Professional		$274.49	$333.22	$641.52
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $278.24 / $555.00 / $597.00	Facility		$278.24	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $192.34 / $192.34 / $192.34	Facility	54	$192.34	$192.34	$192.34
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $236.09 / $351.08 / $861.93	Professional		$236.09	$351.08	$861.93
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 $214.08 / $306.43 / $749.98	Professional		$214.08	$306.43	$749.98
Univera Facility/Professional Facility Modifier Low / Median / High Price $301.66 / $301.66 / $956.72	Facility		$301.66	$301.66	$956.72
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $181.75 / $238.31 / $238.31	Facility	54	$181.75	$238.31	$238.31
Univera Facility/Professional Professional Modifier Low / Median / High Price $198.41 / $303.45 / $631.57	Professional		$198.41	$303.45	$631.57