Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $292.08 / $2,518.00 / $7,235.00	Facility		$292.08	$2,518.00	$7,235.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $182.83 / $239.90 / $343.04	Facility	54	$182.83	$239.90	$343.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.69 / $278.41 / $643.54	Professional		$217.69	$278.41	$643.54
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 $217.24 / $275.45 / $612.85	Professional		$217.24	$275.45	$612.85
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $348.32 / $348.32 / $6,213.00	Facility		$348.32	$348.32	$6,213.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $348.32 / $348.32 / $376.01	Professional		$348.32	$348.32	$376.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $428.72 / $428.72 / $14,648.00	Facility		$428.72	$428.72	$14,648.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $300.10 / $300.10 / $300.10	Facility	54	$300.10	$300.10	$300.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.59 / $380.77 / $936.98	Professional		$252.59	$380.77	$936.98
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $315.54 / $689.47	Facility		$250.00	$315.54	$689.47
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $302.20 / $429.81 / $634.12	Professional		$302.20	$429.81	$634.12
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $259.52 / $259.52 / $259.52	Facility		$259.52	$259.52	$259.52
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $205.02 / $205.02 / $205.02	Facility	54	$205.02	$205.02	$205.02
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $209.64 / $328.98 / $580.33	Professional		$209.64	$328.98	$580.33
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.48 / $364.05 / $705.90	Professional		$309.48	$364.05	$705.90
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $428.72 / $555.00 / $23,612.00	Facility		$428.72	$555.00	$23,612.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $300.10 / $300.10 / $300.10	Facility	54	$300.10	$300.10	$300.10
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $261.27 / $386.39 / $914.62	Professional		$261.27	$386.39	$914.62
United Facility/Professional Facility Modifier Low / Median / High Price $646.00 / $2,705.00 / $4,840.00	Facility		$646.00	$2,705.00	$4,840.00
United Facility/Professional Professional Modifier Low / Median / High Price $231.83 / $324.39 / $801.29	Professional		$231.83	$324.39	$801.29
Univera Facility/Professional Facility Modifier Low / Median / High Price $306.47 / $306.47 / $918.43	Facility		$306.47	$306.47	$918.43
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $205.02 / $242.11 / $242.11	Facility	54	$205.02	$242.11	$242.11
Univera Facility/Professional Professional Modifier Low / Median / High Price $209.64 / $361.67 / $647.83	Professional		$209.64	$361.67	$647.83