Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $336.96 / $2,159.00 / $14,113.00	Facility		$336.96	$2,159.00	$14,113.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $142.88 / $192.54 / $277.64	Facility	52	$142.88	$192.54	$277.64
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $214.32 / $288.81 / $416.46	Facility	54	$214.32	$288.81	$416.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $260.14 / $323.89 / $769.52	Professional		$260.14	$323.89	$769.52
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 $273.35 / $346.61 / $732.33	Professional		$273.35	$346.61	$732.33
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $416.22 / $1,254.00 / $4,050.00	Facility		$416.22	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $416.22 / $416.22 / $459.19	Professional		$416.22	$416.22	$459.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $523.77 / $523.77 / $523.77	Facility		$523.77	$523.77	$523.77
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $419.02 / $419.02 / $419.02	Facility	52	$419.02	$419.02	$419.02
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $366.64 / $366.64 / $366.64	Facility	54	$366.64	$366.64	$366.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.58 / $446.20 / $1,121.10	Professional		$298.58	$446.20	$1,121.10
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $155.00 / $332.00 / $833.13	Facility		$155.00	$332.00	$833.13
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $378.02 / $526.54 / $792.55	Professional		$378.02	$526.54	$792.55
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $324.62 / $324.62 / $324.62	Facility		$324.62	$324.62	$324.62
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $256.45 / $256.45 / $256.45	Facility	54	$256.45	$256.45	$256.45
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $242.47 / $350.51 / $727.41	Professional		$242.47	$350.51	$727.41
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $274.13 / $405.21 / $1,445.85	Facility		$274.13	$405.21	$1,445.85
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $378.89 / $378.89 / $378.89	Professional		$378.89	$378.89	$378.89
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $523.77 / $555.00 / $597.00	Facility		$523.77	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $419.02 / $419.02 / $419.02	Facility	52	$419.02	$419.02	$419.02
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $366.64 / $366.64 / $366.64	Facility	54	$366.64	$366.64	$366.64
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $301.02 / $456.42 / $1,117.50	Professional		$301.02	$456.42	$1,117.50
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 $283.29 / $413.00 / $1,028.90	Professional		$283.29	$413.00	$1,028.90
Univera Facility/Professional Facility Modifier Low / Median / High Price $372.08 / $372.08 / $1,141.21	Facility		$372.08	$372.08	$1,141.21
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $256.45 / $293.94 / $293.94	Facility	54	$256.45	$293.94	$293.94
Univera Facility/Professional Professional Modifier Low / Median / High Price $271.27 / $452.39 / $791.01	Professional		$271.27	$452.39	$791.01