Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $378.53 / $2,865.00 / $7,307.00	Facility		$378.53	$2,865.00	$7,307.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $232.82 / $306.07 / $436.46	Facility	54	$232.82	$306.07	$436.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.58 / $359.32 / $802.05	Professional		$288.58	$359.32	$802.05
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 $290.77 / $368.59 / $793.11	Professional		$290.77	$368.59	$793.11
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $443.49 / $1,254.00 / $4,050.00	Facility		$443.49	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $443.49 / $443.49 / $498.40	Professional		$443.49	$443.49	$498.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $542.54 / $542.54 / $542.54	Facility		$542.54	$542.54	$542.54
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $379.78 / $379.78 / $379.78	Facility	54	$379.78	$379.78	$379.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $321.38 / $486.96 / $1,204.45	Professional		$321.38	$486.96	$1,204.45
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $155.00 / $332.00 / $869.63	Facility		$155.00	$332.00	$869.63
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $399.47 / $567.27 / $836.58	Professional		$399.47	$567.27	$836.58
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $343.04 / $343.04 / $343.04	Facility		$343.04	$343.04	$343.04
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $271.00 / $271.00 / $271.00	Facility	54	$271.00	$271.00	$271.00
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $271.31 / $372.06 / $772.14	Professional		$271.31	$372.06	$772.14
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $376.94 / $478.88 / $916.96	Professional		$376.94	$478.88	$916.96
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $542.54 / $555.00 / $23,612.00	Facility		$542.54	$555.00	$23,612.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $379.78 / $379.78 / $379.78	Facility	54	$379.78	$379.78	$379.78
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $328.52 / $497.28 / $1,188.36	Professional		$328.52	$497.28	$1,188.36
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 $306.26 / $433.46 / $1,058.23	Professional		$306.26	$433.46	$1,058.23
Univera Facility/Professional Facility Modifier Low / Median / High Price $389.94 / $389.94 / $1,226.90	Facility		$389.94	$389.94	$1,226.90
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $271.00 / $308.05 / $308.05	Facility	54	$271.00	$308.05	$308.05
Univera Facility/Professional Professional Modifier Low / Median / High Price $297.01 / $478.06 / $828.97	Professional		$297.01	$478.06	$828.97