Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $405.44 / $2,626.00 / $7,307.00	Facility		$405.44	$2,626.00	$7,307.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $263.39 / $343.25 / $487.72	Facility	54	$263.39	$343.25	$487.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.67 / $399.83 / $922.17	Professional		$328.67	$399.83	$922.17
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 $329.79 / $418.16 / $870.43	Professional		$329.79	$418.16	$870.43
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $497.17 / $1,254.00 / $4,050.00	Facility		$497.17	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $497.17 / $497.17 / $543.48	Professional		$497.17	$497.17	$543.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $606.91 / $606.91 / $606.91	Facility		$606.91	$606.91	$606.91
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $424.84 / $424.84 / $424.84	Facility	54	$424.84	$424.84	$424.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $364.82 / $546.16 / $1,327.09	Professional		$364.82	$546.16	$1,327.09
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $205.00 / $332.10 / $968.67	Facility		$205.00	$332.10	$968.67
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $434.09 / $615.74 / $908.07	Professional		$434.09	$615.74	$908.07
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $372.77 / $372.77 / $372.77	Facility		$372.77	$372.77	$372.77
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $294.49 / $294.49 / $294.49	Facility	54	$294.49	$294.49	$294.49
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $307.68 / $475.00 / $837.91	Professional		$307.68	$475.00	$837.91
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $309.75 / $309.75 / $309.75	Facility		$309.75	$309.75	$309.75
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $449.86 / $516.08 / $1,456.00	Professional		$449.86	$516.08	$1,456.00
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 $424.84 / $424.84 / $424.84	Facility	54	$424.84	$424.84	$424.84
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $367.16 / $550.48 / $1,306.52	Professional		$367.16	$550.48	$1,306.52
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 $344.95 / $485.99 / $1,218.90	Professional		$344.95	$485.99	$1,218.90
Univera Facility/Professional Facility Modifier Low / Median / High Price $435.11 / $435.11 / $1,414.55	Facility		$435.11	$435.11	$1,414.55
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $294.49 / $343.74 / $343.74	Facility	54	$294.49	$343.74	$343.74
Univera Facility/Professional Professional Modifier Low / Median / High Price $307.68 / $494.00 / $925.02	Professional		$307.68	$494.00	$925.02