Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $557.72 / $2,660.00 / $7,185.00	Facility		$557.72	$2,660.00	$7,185.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $342.26 / $454.35 / $624.11	Facility	54	$342.26	$454.35	$624.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $423.98 / $515.72 / $1,121.93	Professional		$423.98	$515.72	$1,121.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,385.00 / $4,133.00 / $9,074.00	Facility		$2,385.00	$4,133.00	$9,074.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $388.68 / $507.11 / $1,137.11	Professional		$388.68	$507.11	$1,137.11
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $642.01 / $1,254.00 / $4,050.00	Facility		$642.01	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $642.01 / $642.01 / $715.06	Professional		$642.01	$642.01	$715.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $778.84 / $778.84 / $778.84	Facility		$778.84	$778.84	$778.84
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $545.19 / $545.19 / $545.19	Facility	54	$545.19	$545.19	$545.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $471.30 / $712.26 / $1,746.10	Professional		$471.30	$712.26	$1,746.10
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $546.00 / $1,237.14	Facility		$332.00	$546.00	$1,237.14
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $565.79 / $803.74 / $1,186.29	Professional		$565.79	$803.74	$1,186.29
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $485.87 / $485.87 / $485.87	Facility		$485.87	$485.87	$485.87
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $383.84 / $383.84 / $383.84	Facility	54	$383.84	$383.84	$383.84
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $414.59 / $621.19 / $1,095.79	Professional		$414.59	$621.19	$1,095.79
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $23,612.00	Facility		$555.00	$597.00	$23,612.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $545.19 / $545.19 / $545.19	Facility	54	$545.19	$545.19	$545.19
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $492.79 / $722.64 / $1,731.79	Professional		$492.79	$722.64	$1,731.79
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 $442.31 / $614.30 / $1,529.77	Professional		$442.31	$614.30	$1,529.77
Univera Facility/Professional Facility Modifier Low / Median / High Price $555.24 / $555.24 / $1,998.64	Facility		$555.24	$555.24	$1,998.64
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $383.84 / $438.64 / $438.64	Facility	54	$383.84	$438.64	$438.64
Univera Facility/Professional Professional Modifier Low / Median / High Price $414.59 / $677.11 / $1,180.40	Professional		$414.59	$677.11	$1,180.40