Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $304.91 / $2,865.00 / $7,307.00	Facility		$304.91	$2,865.00	$7,307.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $190.39 / $250.48 / $359.58	Facility	54	$190.39	$250.48	$359.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.50 / $281.70 / $561.26	Professional		$226.50	$281.70	$561.26
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 $235.52 / $298.63 / $643.82	Professional		$235.52	$298.63	$643.82
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $364.32 / $364.32 / $4,050.00	Facility		$364.32	$364.32	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $364.32 / $364.32 / $402.99	Professional		$364.32	$364.32	$402.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $449.16 / $449.16 / $14,648.00	Facility		$449.16	$449.16	$14,648.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $314.41 / $314.41 / $314.41	Facility	54	$314.41	$314.41	$314.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $263.18 / $393.69 / $982.22	Professional		$263.18	$393.69	$982.22
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $210.00 / $329.04 / $718.22	Facility		$210.00	$329.04	$718.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $325.13 / $461.04 / $679.75	Professional		$325.13	$461.04	$679.75
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $279.20 / $279.20 / $279.20	Facility		$279.20	$279.20	$279.20
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $220.57 / $220.57 / $220.57	Facility	54	$220.57	$220.57	$220.57
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.74 / $354.81 / $625.89	Professional		$212.74	$354.81	$625.89
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $327.27 / $327.27 / $737.05	Professional		$327.27	$327.27	$737.05
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $449.16 / $555.00 / $597.00	Facility		$449.16	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $314.41 / $314.41 / $314.41	Facility	54	$314.41	$314.41	$314.41
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $267.39 / $401.15 / $969.11	Professional		$267.39	$401.15	$969.11
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 $249.03 / $349.87 / $888.91	Professional		$249.03	$349.87	$888.91
Univera Facility/Professional Facility Modifier Low / Median / High Price $321.24 / $321.24 / $965.65	Facility		$321.24	$321.24	$965.65
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $220.57 / $253.78 / $253.78	Facility	54	$220.57	$253.78	$253.78
Univera Facility/Professional Professional Modifier Low / Median / High Price $237.99 / $389.09 / $682.94	Professional		$237.99	$389.09	$682.94