Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $281.27 / $2,399.00 / $7,168.00	Facility		$281.27	$2,399.00	$7,168.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $190.82 / $253.37 / $361.21	Facility	54	$190.82	$253.37	$361.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $229.87 / $298.67 / $749.71	Professional		$229.87	$298.67	$749.71
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 $240.43 / $304.86 / $662.25	Professional		$240.43	$304.86	$662.25
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $366.21 / $366.21 / $4,050.00	Facility		$366.21	$366.21	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $366.21 / $366.21 / $410.61	Professional		$366.21	$366.21	$410.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $451.20 / $451.20 / $14,648.00	Facility		$451.20	$451.20	$14,648.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $315.83 / $315.83 / $315.83	Facility	54	$315.83	$315.83	$315.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.11 / $393.52 / $974.58	Professional		$264.11	$393.52	$974.58
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $332.00 / $722.34	Facility		$250.00	$332.00	$722.34
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $331.10 / $469.96 / $693.02	Professional		$331.10	$469.96	$693.02
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $284.33 / $284.33 / $284.33	Facility		$284.33	$284.33	$284.33
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $224.62 / $224.62 / $224.62	Facility	54	$224.62	$224.62	$224.62
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $215.67 / $361.41 / $637.54	Professional		$215.67	$361.41	$637.54
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $402.12 / $402.12 / $402.12	Facility		$402.12	$402.12	$402.12
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $337.61 / $392.86 / $750.56	Professional		$337.61	$392.86	$750.56
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $451.20 / $555.00 / $597.00	Facility		$451.20	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $315.83 / $315.83 / $315.83	Facility	54	$315.83	$315.83	$315.83
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $277.08 / $404.13 / $974.49	Professional		$277.08	$404.13	$974.49
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 $258.64 / $360.14 / $889.93	Professional		$258.64	$360.14	$889.93
Univera Facility/Professional Facility Modifier Low / Median / High Price $322.70 / $322.70 / $944.98	Facility		$322.70	$322.70	$944.98
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $224.62 / $254.94 / $254.94	Facility	54	$224.62	$254.94	$254.94
Univera Facility/Professional Professional Modifier Low / Median / High Price $240.64 / $375.87 / $686.06	Professional		$240.64	$375.87	$686.06