Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $324.14 / $2,792.00 / $7,307.00	Facility		$324.14	$2,792.00	$7,307.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $200.36 / $262.54 / $372.58	Facility	54	$200.36	$262.54	$372.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.30 / $295.43 / $626.30	Professional		$240.30	$295.43	$626.30
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 $243.15 / $308.31 / $672.09	Professional		$243.15	$308.31	$672.09
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $379.49 / $1,254.00 / $4,050.00	Facility		$379.49	$1,254.00	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $379.49 / $379.49 / $415.78	Professional		$379.49	$379.49	$415.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $464.51 / $464.51 / $464.51	Facility		$464.51	$464.51	$464.51
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $325.16 / $325.16 / $325.16	Facility	54	$325.16	$325.16	$325.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $276.07 / $417.45 / $1,023.20	Professional		$276.07	$417.45	$1,023.20
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $340.13 / $743.36	Facility		$250.00	$340.13	$743.36
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $333.28 / $473.00 / $697.56	Professional		$333.28	$473.00	$697.56
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $286.20 / $286.20 / $286.20	Facility		$286.20	$286.20	$286.20
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $226.10 / $226.10 / $226.10	Facility	54	$226.10	$226.10	$226.10
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.95 / $363.81 / $641.77	Professional		$234.95	$363.81	$641.77
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $345.81 / $345.81 / $345.81	Facility		$345.81	$345.81	$345.81
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $343.80 / $404.46 / $783.25	Professional		$343.80	$404.46	$783.25
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $464.51 / $555.00 / $23,612.00	Facility		$464.51	$555.00	$23,612.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $325.16 / $325.16 / $325.16	Facility	54	$325.16	$325.16	$325.16
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $280.82 / $423.46 / $1,018.15	Professional		$280.82	$423.46	$1,018.15
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 $257.99 / $358.31 / $850.60	Professional		$257.99	$358.31	$850.60
Univera Facility/Professional Facility Modifier Low / Median / High Price $332.62 / $332.62 / $1,051.54	Facility		$332.62	$332.62	$1,051.54
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $226.10 / $262.77 / $262.77	Facility	54	$226.10	$262.77	$262.77
Univera Facility/Professional Professional Modifier Low / Median / High Price $247.39 / $398.85 / $707.12	Professional		$247.39	$398.85	$707.12