Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $300.56 / $2,660.00 / $9,038.00	Facility		$300.56	$2,660.00	$9,038.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $193.40 / $246.19 / $361.75	Facility	54	$193.40	$246.19	$361.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.19 / $280.67 / $601.25	Professional		$231.19	$280.67	$601.25
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 $225.05 / $285.36 / $649.16	Professional		$225.05	$285.36	$649.16
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $368.02 / $368.02 / $4,050.00	Facility		$368.02	$368.02	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $368.02 / $368.02 / $383.78	Professional		$368.02	$368.02	$383.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $450.36 / $450.36 / $450.36	Facility		$450.36	$450.36	$450.36
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $315.25 / $315.25 / $315.25	Facility	54	$315.25	$315.25	$315.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.88 / $391.04 / $991.06	Professional		$266.88	$391.04	$991.06
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $319.00 / $721.33	Facility		$130.00	$319.00	$721.33
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $308.94 / $438.36 / $646.47	Professional		$308.94	$438.36	$646.47
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $265.30 / $265.30 / $265.30	Facility		$265.30	$265.30	$265.30
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $209.59 / $209.59 / $209.59	Facility	54	$209.59	$209.59	$209.59
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $215.58 / $336.93 / $594.36	Professional		$215.58	$336.93	$594.36
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $317.38 / $373.38 / $377.49	Professional		$317.38	$373.38	$377.49
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $450.36 / $555.00 / $597.00	Facility		$450.36	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $315.25 / $315.25 / $315.25	Facility	54	$315.25	$315.25	$315.25
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $266.88 / $400.61 / $974.13	Professional		$266.88	$400.61	$974.13
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 $237.94 / $354.29 / $839.66	Professional		$237.94	$354.29	$839.66
Univera Facility/Professional Facility Modifier Low / Median / High Price $322.72 / $322.72 / $1,008.81	Facility		$322.72	$322.72	$1,008.81
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $209.59 / $254.95 / $254.95	Facility	54	$209.59	$254.95	$254.95
Univera Facility/Professional Professional Modifier Low / Median / High Price $215.58 / $369.73 / $682.17	Professional		$215.58	$369.73	$682.17