Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $396.62 / $2,626.00 / $7,235.00	Facility		$396.62	$2,626.00	$7,235.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $248.96 / $326.10 / $464.33	Facility	54	$248.96	$326.10	$464.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.51 / $364.16 / $786.81	Professional		$293.51	$364.16	$786.81
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 $279.56 / $365.45 / $831.29	Professional		$279.56	$365.45	$831.29
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $471.84 / $1,254.00 / $4,050.00	Facility		$471.84	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $471.84 / $471.84 / $513.38	Professional		$471.84	$471.84	$513.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $578.13 / $578.13 / $578.13	Facility		$578.13	$578.13	$578.13
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $404.69 / $404.69 / $404.69	Facility	54	$404.69	$404.69	$404.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.84 / $514.46 / $1,270.81	Professional		$342.84	$514.46	$1,270.81
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $160.00 / $332.00 / $924.30	Facility		$160.00	$332.00	$924.30
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $411.44 / $583.82 / $861.01	Professional		$411.44	$583.82	$861.01
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $353.32 / $353.32 / $353.32	Facility		$353.32	$353.32	$353.32
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $279.12 / $279.12 / $279.12	Facility	54	$279.12	$279.12	$279.12
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $285.45 / $450.37 / $794.47	Professional		$285.45	$450.37	$794.47
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $423.65 / $423.65 / $428.31	Professional		$423.65	$423.65	$428.31
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $578.13 / $23,612.00	Facility		$555.00	$578.13	$23,612.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $404.69 / $404.69 / $404.69	Facility	54	$404.69	$404.69	$404.69
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $349.18 / $525.46 / $1,254.83	Professional		$349.18	$525.46	$1,254.83
United Facility/Professional Facility Modifier Low / Median / High Price $964.00 / $2,871.00 / $4,851.00	Facility		$964.00	$2,871.00	$4,851.00
United Facility/Professional Professional Modifier Low / Median / High Price $324.83 / $458.88 / $1,145.59	Professional		$324.83	$458.88	$1,145.59
Univera Facility/Professional Facility Modifier Low / Median / High Price $414.83 / $414.83 / $1,292.01	Facility		$414.83	$414.83	$1,292.01
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $279.12 / $327.72 / $327.72	Facility	54	$279.12	$327.72	$327.72
Univera Facility/Professional Professional Modifier Low / Median / High Price $306.25 / $492.39 / $881.90	Professional		$306.25	$492.39	$881.90