Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.93 / $2,626.00 / $7,235.00	Facility		$288.93	$2,626.00	$7,235.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $181.14 / $240.74 / $349.48	Facility	54	$181.14	$240.74	$349.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.78 / $275.27 / $574.40	Professional		$221.78	$275.27	$574.40
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 $217.19 / $275.39 / $608.13	Professional		$217.19	$275.39	$608.13
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $344.44 / $344.44 / $4,050.00	Facility		$344.44	$344.44	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $344.44 / $344.44 / $376.43	Professional		$344.44	$344.44	$376.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $423.44 / $423.44 / $14,648.00	Facility		$423.44	$423.44	$14,648.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $296.41 / $296.41 / $296.41	Facility	54	$296.41	$296.41	$296.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.18 / $376.57 / $925.60	Professional		$250.18	$376.57	$925.60
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $324.50 / $680.22	Facility		$250.00	$324.50	$680.22
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $303.12 / $430.29 / $634.42	Professional		$303.12	$430.29	$634.42
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $260.30 / $260.30 / $260.30	Facility		$260.30	$260.30	$260.30
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $205.64 / $205.64 / $205.64	Facility	54	$205.64	$205.64	$205.64
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $207.98 / $330.20 / $582.47	Professional		$207.98	$330.20	$582.47
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.72 / $364.37 / $708.38	Professional		$309.72	$364.37	$708.38
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $423.44 / $555.00 / $597.00	Facility		$423.44	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $296.41 / $296.41 / $296.41	Facility	54	$296.41	$296.41	$296.41
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $258.83 / $382.36 / $915.83	Professional		$258.83	$382.36	$915.83
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 $232.13 / $328.72 / $802.66	Professional		$232.13	$328.72	$802.66
Univera Facility/Professional Facility Modifier Low / Median / High Price $302.95 / $302.95 / $922.94	Facility		$302.95	$302.95	$922.94
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $205.64 / $239.33 / $239.33	Facility	54	$205.64	$239.33	$239.33
Univera Facility/Professional Professional Modifier Low / Median / High Price $224.53 / $362.76 / $644.04	Professional		$224.53	$362.76	$644.04