Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $600.25 / $2,626.00 / $8,521.00	Facility		$600.25	$2,626.00	$8,521.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $409.40 / $516.41 / $705.17	Facility	54	$409.40	$516.41	$705.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $506.12 / $588.70 / $1,435.34	Professional		$506.12	$588.70	$1,435.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $472.73 / $472.73 / $472.73	Professional		$472.73	$472.73	$472.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,385.00 / $4,133.00 / $9,074.00	Facility		$2,385.00	$4,133.00	$9,074.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $469.31 / $613.48 / $1,308.03	Professional		$469.31	$613.48	$1,308.03
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $725.77 / $1,990.00 / $8,917.50	Facility		$725.77	$1,990.00	$8,917.50
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $725.77 / $725.77 / $769.22	Professional		$725.77	$725.77	$769.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $879.98 / $879.98 / $879.98	Facility		$879.98	$879.98	$879.98
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $615.99 / $615.99 / $615.99	Facility	54	$615.99	$615.99	$615.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $532.58 / $812.54 / $1,972.86	Professional		$532.58	$812.54	$1,972.86
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $572.00 / $1,395.56	Facility		$332.00	$572.00	$1,395.56
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $605.39 / $859.59 / $1,393.92	Professional		$605.39	$859.59	$1,393.92
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $519.87 / $519.87 / $519.87	Facility		$519.87	$519.87	$519.87
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $410.69 / $410.69 / $410.69	Facility	54	$410.69	$410.69	$410.69
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $451.46 / $663.91 / $1,171.15	Professional		$451.46	$663.91	$1,171.15
Highmark BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,787.88 / $2,641.13 / $5,601.80	Facility		$1,787.88	$2,641.13	$5,601.80
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $644.57 / $735.40 / $1,367.77	Professional		$644.57	$735.40	$1,367.77
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $555.00 / $597.00 / $879.98	Facility		$555.00	$597.00	$879.98
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $615.99 / $615.99 / $615.99	Facility	54	$615.99	$615.99	$615.99
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $534.84 / $820.53 / $1,910.19	Professional		$534.84	$820.53	$1,910.19
United Facility/Professional Facility Modifier Low / Median / High Price $1,348.00 / $3,496.00 / $6,201.00	Facility		$1,348.00	$3,496.00	$6,201.00
United Facility/Professional Professional Modifier Low / Median / High Price $491.76 / $702.04 / $1,738.22	Professional		$491.76	$702.04	$1,738.22
Univera Facility/Professional Facility Modifier Low / Median / High Price $626.40 / $626.40 / $2,273.61	Facility		$626.40	$626.40	$2,273.61
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $410.69 / $494.85 / $494.85	Facility	54	$410.69	$494.85	$494.85
Univera Facility/Professional Professional Modifier Low / Median / High Price $501.99 / $724.48 / $1,324.10	Professional		$501.99	$724.48	$1,324.10