Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $310.82 / $2,626.00 / $9,038.00	Facility		$310.82	$2,626.00	$9,038.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $210.70 / $278.24 / $395.75	Facility	54	$210.70	$278.24	$395.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.60 / $309.83 / $669.79	Professional		$251.60	$309.83	$669.79
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 $254.54 / $322.75 / $708.35	Professional		$254.54	$322.75	$708.35
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $402.16 / $402.16 / $4,050.00	Facility		$402.16	$402.16	$4,050.00
CDPHP Facility/Professional Professional Modifier Low / Median / High Price $402.16 / $402.16 / $436.54	Professional		$402.16	$402.16	$436.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $492.90 / $492.90 / $14,648.00	Facility		$492.90	$492.90	$14,648.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $345.03 / $345.03 / $345.03	Facility	54	$345.03	$345.03	$345.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $292.36 / $440.24 / $1,083.83	Professional		$292.36	$440.24	$1,083.83
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $332.00 / $788.65	Facility		$250.00	$332.00	$788.65
Emblem Health Facility/Professional Professional Modifier Low / Median / High Price $350.98 / $497.52 / $733.42	Professional		$350.98	$497.52	$733.42
Excellus BCBS Facility/Professional Facility Modifier Low / Median / High Price $301.39 / $301.39 / $301.39	Facility		$301.39	$301.39	$301.39
Excellus BCBS Facility/Professional Facility Modifier 54 Low / Median / High Price $238.11 / $238.11 / $238.11	Facility	54	$238.11	$238.11	$238.11
Excellus BCBS Facility/Professional Professional Modifier Low / Median / High Price $243.55 / $382.98 / $675.58	Professional		$243.55	$382.98	$675.58
Highmark BCBS Facility/Professional Professional Modifier Low / Median / High Price $361.53 / $425.32 / $823.39	Professional		$361.53	$425.32	$823.39
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $492.90 / $555.00 / $597.00	Facility		$492.90	$555.00	$597.00
MVP Health Care Facility/Professional Facility Modifier 54 Low / Median / High Price $345.03 / $345.03 / $345.03	Facility	54	$345.03	$345.03	$345.03
MVP Health Care Facility/Professional Professional Modifier Low / Median / High Price $297.94 / $446.29 / $1,066.84	Professional		$297.94	$446.29	$1,066.84
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 $270.51 / $386.60 / $953.26	Professional		$270.51	$386.60	$953.26
Univera Facility/Professional Facility Modifier Low / Median / High Price $353.36 / $353.36 / $1,069.71	Facility		$353.36	$353.36	$1,069.71
Univera Facility/Professional Facility Modifier 54 Low / Median / High Price $238.11 / $279.16 / $279.16	Facility	54	$238.11	$279.16	$279.16
Univera Facility/Professional Professional Modifier Low / Median / High Price $260.42 / $420.04 / $751.22	Professional		$260.42	$420.04	$751.22