Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.25 / $2,559.00 / $9,038.00	Facility		$363.25	$2,559.00	$9,038.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $234.66 / $298.58 / $439.17	Facility	54	$234.66	$298.58	$439.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.16 / $349.25 / $788.46	Professional		$275.16	$349.25	$788.46
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 $276.55 / $350.66 / $778.22	Professional		$276.55	$350.66	$778.22
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $447.18 / $447.18 / $4,050.00	Facility		$447.18	$447.18	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $447.18 / $447.18 / $473.92	Professional		$447.18	$447.18	$473.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $547.30 / $547.30 / $547.30	Facility		$547.30	$547.30	$547.30
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $383.12 / $383.12 / $383.12	Facility	54	$383.12	$383.12	$383.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $319.05 / $474.39 / $1,157.58	Professional		$319.05	$474.39	$1,157.58
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $160.00 / $332.00 / $878.42	Facility		$160.00	$332.00	$878.42
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $379.41 / $538.80 / $794.70	Professional		$379.41	$538.80	$794.70
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $325.82 / $325.82 / $325.82	Facility		$325.82	$325.82	$325.82
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $257.39 / $257.39 / $257.39	Facility	54	$257.39	$257.39	$257.39
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.48 / $413.68 / $729.74	Professional		$263.48	$413.68	$729.74
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $320.75 / $393.10 / $878.56	Professional		$320.75	$393.10	$878.56
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $547.30 / $555.00 / $597.00	Facility		$547.30	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $383.12 / $383.12 / $383.12	Facility	54	$383.12	$383.12	$383.12
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $327.33 / $483.63 / $1,133.83	Professional		$327.33	$483.63	$1,133.83
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 $292.38 / $418.54 / $1,027.84	Professional		$292.38	$418.54	$1,027.84
Univera Facility/Professional Facility Modifier Low / Median / High Price $392.36 / $392.36 / $1,215.08	Facility		$392.36	$392.36	$1,215.08
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $257.39 / $309.95 / $309.95	Facility	54	$257.39	$309.95	$309.95
Univera Facility/Professional Professional Modifier Low / Median / High Price $281.30 / $430.23 / $829.38	Professional		$281.30	$430.23	$829.38